Overview
The Privileging Specialist verifies the qualifications, licenses, and experience of healthcare providers to grant authority for specific medical acts within a facility, ensuring compliance with regulatory and organizational standards. This Specialist will manage the full lifecycle of provider onboarding, including application processing, background checks, and will maintain accurate records for accreditation.
Essential Functions
* Verify education, training, work history, board certifications, and licensure for doctors and APPs.
* Manage the appointment, reappointment, and delineation of clinical privileges of doctors and APPs.
* Ensure adherence to NCQA, JCAHO, state and federal standards.
* Maintain and update detailed provider records in credentialing database(s).
* Act as liaison and communicate with providers, medical staff offices and licensing boards.
* Help coordinate and obtain peer-to-peer references.
* Submit and maintain applications submitted to facilities.
* Maintain and update databases for facilities and practitioners.
* Collaborate with internal teams to ensure smooth transition for new practices and providers.
* Obtain and organize information and documentation pertinent to practices and providers.
* Track status of activities and provide updates to internal departments.
* Document processes and procedures for privileging activities.
* Participate in special projects and complete other duties as assigned.
Qualifications And Education Requirements
* High School Diploma or equivalent; associate or bachelor’s degree preferred.
* 3+ years in the healthcare industry.
* Compliance with all HIPAA policies.
* Microsoft Office experience (Excel, Word, Outlook, PowerPoint).
* Excellent organization and communication skills.
* Ability to handle multiple projects simultaneously in a fast-paced environment.
* Satisfactory criminal background check.
* StrideCare is an Equal Opportunity Employer and is committed to diversity and inclusion in our workforce. We encourage applications from candidates of all backgrounds and experiences.
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