Credentialing Specialist I
Boston, MA 
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Posted 9 days ago
Job Description
Job Posting Description

At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.

The Credentialing Specialist I will be responsible for:
  • Processing applications for appointment, re-appointment, and mid-cycle change to the Medical Staff, House Staff, and Associate Clinical Staff, and requesting clinical privileges, as applicable, in a customer-focused, efficient, comprehensive, timely, and accurate manner.
  • Reviewing and evaluating applications, including evidence of education, training, experience, and competency, to determine eligibility for membership and clinical privileges.
  • Obtaining primary source verifications for all information submitted by the applicant or re-applicant.
  • Recognizing, investigating, and validating discrepancies and adverse information obtained from the application, primary source verifications, or other sources; obtaining clarification and escalating concerns.
  • Notifying applicants and re-applicants, and their coordinators, of any issues and maintaining contact with them throughout the process.
  • Compiling, evaluating, and presenting practitioner-specific data collected for review by one or more decision-making bodies in a comprehensive and timely manner.
  • Documenting, according to policy and procedure, applicants and re-applicants with potential issues in a holistic and comprehensive manner.
  • Soliciting and obtaining information from the Department or Division Chief regarding applicants and re-applicants.
  • Escalating concerns, according to policy and procedure, to the chain of command.
  • Performing related credentialing functions, including ensuring all documents are maintained according to policy and procedure.
  • Maintaining confidential credentialing files for all applicants and members of the Medical Staff, House Staff, and Associate Clinical Staff.
  • Enrolling, maintaining enrollment, and terminating members of the Medical Staff, House Staff, and Associate Clinical Staff with the appropriate institutional malpractice carrier.
  • Providing the highest level of service to all customers (internal and external) as demonstrated through the core values of the enterprise.
  • Implementing office goals and objectives using continuous process improvement methods.
  • Maintaining relationships and serving as a liaison between Medical Staff Services and clinical departments and divisions, and their Chief(s), enterprise-wide, to address questions and concerns.
  • Teaching and providing expertise to managers, medical staff, and staff on credentialing processes, requirements, and regulations.
  • Applying relevant Medical Staff Bylaws, Rules and Regulations, and any other relevant regulatory standards to the day-to-day functioning.
  • Creating a customer-friendly and healthy work environment in support of employee engagement and well-being.
  • Assisting in facilitating an efficient, productive, accountable, and customer and quality-oriented work environment using high-reliability principles.
  • Providing and ensuring the highest level of service to all customers (internal and external) as demonstrated through the core values of the enterprise.

To qualify you must have:

  • Associate's Degree in the field of Medical Staff Services Science, Health Care Administration or a closely related field, or one year of basic technical training
  • One year of related experience in a hospital or healthcare environment
  • One year of experience in credentialing, provider enrollment or closely related field.
  • Attention to detail, managing multiple tasks simultaneously, identifying and escalating concerns, and meticulous organization
Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

LI#Remote

Boston Children's Hospital requires all employees to be vaccinated against COVID-19 and Flu, (unless you are eligible for a medical or religious exemption).

Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Associate Degree
Required Experience
1 year
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