System Credentialing Specialist

Your job is more than a job The System Credentialing Specialist is responsible for the System Verification Office (SVO) credentialing and re\-credentialing of medical and allied staff performed on behalf of LCMC facilities. Supports departmental activities to ensure quality in conducting, maintaining, and communicating clinical staff credentialing and primary source verifications. Monitors statuses of the credentialing process for the medical and mid\-level practitioners at LCMC Health. GENERAL DUTIES: * Organizes and maintains provider data and files. Processes applications timely and ensures that quality benchmarks are met with regards to turnaround times, accuracy of information, other SVO and regulatory metrics, and in accordance with external requirements (accreditation, federal, and state). * Executes credentialing application and data collection, application processing, primary source verification for all new applicants and applicants for re\-credentialing. Assures applications are correct, complete, and resolves discrepancies in compliance with regulatory requirements. * Provides and supports ongoing communication with SVO Leaders, especially in regards to risk/issues identified during the credentialing/recredentialing process. * Follows all regulatory requirements related to the primary source verification process for medical/allied health staff and managed care compliance. * Maintains awareness of The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Center for Medicare/Medicaid (CMS), and other regulatory compliance guidelines through LCMC SVO provided continuing education. * Demonstrates excellent professional communication skills while interacting with colleagues, customer relations and MSO representatives, and leadership to collect missing information or resolve issues. * Assures confidentiality is maintained at all times in all aspects of the SVO credentialing process and for practitioners. * Performs daily office duties such