Credentialing Specialist

Current Employees:

If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

RCH Medical Staff Services

Scheduled Weekly Hours

40

Starting Pay Rate Range

$20.96 - $26.20

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

Credentialing Specialists are responsible for completing credentialing and recredentialing activities, including verifying and maintaining the professional qualifications of physicians and providers to ensure compliance with regulatory standards (e.g., NCQA, The Joint Commission). The role also ensures the accuracy and integrity of credentialing data by maintaining complete, current, and up-to-date information in credentialing software systems and electronic files.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

• Supportive work culture
• Medical, Vision and Dental Coverage
• Retirement Plans, Health Savings Account, and Flexible Spending Account
• Instant pay is available for qualifying positions
• Paid Time Off Accrual Bank
• Opportunities for growth and advancement
• Tuition assistance/reimbursement
• Excellent pay differentials on qualifying positions
• Flexible scheduling

Job Description

Essential Functions:

• Responsible for processing initial and reappointment applications, performing primary source verifications including, but not limited to, board certifications, state licenses, professional databanks, federations, credential verification, and exclusion checks.
• Communicates necessary information and requests to the Vice President Medical Affairs, Medical Staff Coordinator, and other department staff.
• Maintains, monitors, and reports expirations of physician and practitioner licenses, insurance, DEA numbers, TB test results, and other items as required.
• Maintains accurate, current physician and provider records through timely data entry and ongoing updates in credentialing databases and electronic files to support task tracking, provider communication, and secure document management.
• Collaborates with internal stakeholders and external agencies to obtain, validate, and maintain accurate physician and provider data.
• Communicates with physicians and providers to resolve discrepancies and obtain missing information throughout the credentialing and recredentialing process.
• Maintains up-to-date knowledge of industry regulations and standards, ensuring full compliance at all times.
• Assists and guides internal staff to ensure accurate and efficient completion of credentialing activities.
• All other duties as assigned.

Additional Requirements

Required:

Education - High School Diploma/GED Equivalent in General Studies

Experience - Minimum 1 year healthcare experience

Preferred:

Education - Associates degree in Healthcare

Experience - 3+ years of Administrative Experience; 3+ years of Healthcare Experience

Physical Requirements:

Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Business Administration

Job Family

Business Services

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

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Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.