Credentialing Specialist III
Company: Johns Hopkins Health Care
Posted on: October 13, 2019
Credentialing Specialist III Requisition #: 190203
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Clerical and Administrative Support
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: Sept. 6, 2019
Johns Hopkins Health System employs more than 20,000 people
annually. Upon joining Johns Hopkins Health System, you become part
of a diverse organization dedicated to its patients, their
families, and the community we serve, as well as to our employees.
Career opportunities are available in academic and community
hospital settings, home care services, physician practices,
international affiliate locations and in the health insurance
industry. If you share in our vision, mission and values and also
have exceptional customer service and technical skills, we invite
you to join those who are leaders and innovators in the healthcare
This highly visibility position reports to the Credentialing
Supervisor and is accountable for processing high risk
credentialing files. Coordinate meetings with Chairman of the
Special Credentials Review Committee (SCRC) Board, legal counsel
and board members. Create, prepare and present reports to the SCRC.
Create, scan and print risk assessments packets for SCRC. Create
and prepare additional reports as necessary. Schedule and attend
legal meetings and appeal hearings. Create meeting agenda and
minutes. Ability to manage a very demanding workload with strict
deadlines. Must have outstanding written, oral and interpersonal
skills. Ability to effectively communicate with internal and
external sources such as attorneys, medical directors and
providers. Requires analytical ability to coordinator information
from a variety of sources, detect errors and subtle inconsistencies
in documentation. This position is highly visible throughout the
entire Health System.
- Education: Requires a professional level of business
administration and/or management generally obtained in the first
two years of college or equivalent work-related experience.
Bachelor's degree preferred.
Requires comprehensive understanding of credentialing policies and
procedures as well as accreditation and regulatory requirements
relating to managed care.
Must be able to communicate effectively, both orally and in writing
with diverse groups of people within the Health System. Must have
intermediate PC skills to include MicroSoft Office, Word, Excel,
including PC keyboard skills with exceptional accuracy and
efficiency. Knowledge of scanning equipment is preferred. Ability
to manage demanding workload; be self-motivated; be able to carry
out responsibilities with minimum supervision. Requires
organizational skills to prioritize tasks in order to meet
Adheres to professional confidentiality standards in accordance
with legal, ethical, and departmental policies. Demonstrated
ability to manage and resolve difficult situations.
D. Required Licensure, Certification, Etc.:
CPMSM or CPCS preferred but not required
E. Work Experience:
Requires thorough knowledge of provider credentialing, principles,
methods and procedures normally acquired through a minimum of 3
years of credentialing experience. Demonstrated experience in the
managed care credentialing environment such as a CVO, MCO, HMO or
Hospital Based Credentialing (MSO).
F. Machines, Tools, Equipment:
PC, PC software applications, scanning equipment, and general
office equipment. Familiarity with Vistar, Mc400, IDX and DHMH or
similar systems is preferred.
Johns Hopkins Health System and its affiliates are Equal
Opportunity/Affirmative Action employers. All qualified applicants
will receive consideration for employment without regard to race,
color, religion, sexual orientation, gender identity, sex, age,
national origin, disability, protected veteran status, and or any
other status protected by federal, state, or local law.
Established in 1995, Johns Hopkins HealthCare (JHHC) is the health
insurance division of Johns Hopkins Medicine, and a critical
partner in the Hopkins--- tripartite mission of patient care,
education and research. JHHC is driven by a member-centered
strategy to provide excellent service, improve health and reduce
costs.-- And through data-driven analytics and innovative
approaches, JHHC assures that all 400,000 plan members receive
efficient and effective coordinated care.
Keywords: Johns Hopkins Health Care, Baltimore , Credentialing Specialist III, Other , Hanover, Maryland
Didn't find what you're looking for? Search again!