Credentialing Specialist (College of Medicine) - (STA008573)

Additional Posting Information :

This position will support the opening of a new community clinic on the UH Campus by assisting with the development of credentiling and associated processes. This includes health plan/insurance and provider credentialing.

Description

Ensures medical staff members' and prospective employee's maintain current credentials and licenses to workLegally in their field or specialty.

1. Maintains compliance with all applicable regulatory and accrediting local, state, and federal institutions.
2. Reviews information on potential new employees to make sure all required licenses and credentials are currentbefore hiring.
3. Monitors & Advises staff/faculty/residence/student credentials and licenses on renewal procedures.
4. Supports staff/faculty/residence/student in the credential and licensing process; provides assistance toStaff/faculty/residence/student on renewal of credentials and licensing.
5. Participates in the development of internal credentialing processes; may train others on credentialing processes.
6. Initiates and Manages records in licenses, credentials, and insurance contracts.
7. Release information to agencies and members of the public as required by law.
8. May serve on various committees.
9. Actively monitors and ensures compliance in accordance with Centers for Medicare & Medicaid Services (CMS)Fraud, Waste and Abuse.
10. May maintain protected health information (PHI) documentation in accordance with Health Insurance Portabilityand Accountability Act (HIPAA). Other duties as assigned.

EEO/AA

Qualifications :

Associates and 3 years experience

Requires the ability and knowledge for analysis and interpretation of procedures, policiesand practices attainable through specific education and/or training programs in aspecialty or technical field. Advanced vocational or electronic skills or a basic knowledgeof a professional field is required. An Associate's degree or certification/licensing in atechnical specialty program of over 18 months and up to 3 years duration arecharacteristic of this field.

Requires a minimum of three (3) years of directly job-related experience.

*Education in lieu of experience and experience in lieu of education will be considered.