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Job Title

Credentialing Specialist

Department

University Hospital | Credentialing Services

Scope Of Position

The Credentialing Specialist will assume total responsibility of credentialing of providers from hire to enrollment in managed care plans. The Credentialing Specialist provides services for all entities within the healthcare system.

Position Summary

Primary responsibility will be initiating and monitoring the provider corporate credentialing functions to assure that all practitioners are credentialed in accordance with established thresholds. This would include primary source verification and medical staff privileging assuring compliance with NCQA and JCAHO standards. Also, responsibility will include enrollment into governmental payor plans (Medicare, Medicaid, Bureau of Workers Compensation, etc.) and enrollment into other non-delegated health plans. CVO Specialist may also be asked to work on special projects for providers, which might include assisting with credentialing process for other healthcare institutions when a business relationship exists. This position requires excellent verbal and written communication skills and the ability to work independently, while managing multiple priorities.

Required Qualifications

• Bachelor's degree in health related or educational field
• 4 years experience in a hospital setting and/or managed care setting or equivalent combination of education and experience
• Strong verbal and written communication skills; Strong organizational skills and attention to detail
• Ability to work with minimal supervision and to maintain confidentiality due to access to sensitive information
• Ability to problem solve and think creatively
• Knowledge of NCQA and JCAHO as they relate to current credentialing and re-credentialing standards
• Working knowledge of Microsoft Word and Excel
• CPMSM or CPCS certification preferred
  
  

Our Comprehensive Employee Benefits Include

• An array of retirement plan options, each with a generous employer contribution.
• Affordable health insurance options, including dental, vision and prescription coverage that begin on day one.
• Paid vacation and sick leave, including short and long-term disability and paid parental leave.
• Get the most out of the Public Service Loan Forgiveness program.
• And much more!
  
  

Additional Information

Location:

Doan Hall (0089)

Position Type

Regular

Scheduled Hours

40

Shift

First Shift

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.

The university is an equal opportunity employer, including veterans and disability.