Privileging Specialist

📋 Description

• • Maintain and update electronic provider records accurately and in a timely manner to reflect changes in provider status, credentials, and privileges.
• • Obtain, verify, and secure all required documentation and attestations to ensure compliance with internal policies and external regulatory standards.
• • Support the creation of abbreviated CVs tailored for privileging applications and credentialing workflows.
• • Request and track Conflict of Interest (COI) disclosures for assigned healthcare sites in accordance with established procedures.
• • Ensure all providers are properly registered with state Patient Compensation Funds by liaising directly with the risk management department.
• • Notify Onboarding teams of site-specific training, orientations, certifications, or educational requirements necessary for privilege approval, and monitor completion status.
• • Assign, review, and ensure timely completion of reappointments, enrollments, reference checks, and other credentialing tasks through the OSS system.
• • Serve as the primary point of contact for medical staff professionals at affiliated facilities, responding promptly to inquiries and facilitating resolution of outstanding credentialing items.
• • Maintain current knowledge of site-specific workflows, meeting schedules, procedural requirements, and documentation protocols, ensuring all systems and records reflect recent changes.
• • Conduct regular follow-ups with providers, medical staff offices, and external agencies via phone, email, and other communication channels to advance credentialing processes.
• • Complete end-to-end submission of initial applications, reappointments, add/change requests, and enrollment applications, including securing all supporting documentation such as state licenses, NPPES updates, and government health plan logins.
• • Participate in corporate-sponsored training sessions, both remote and in-person, to stay current on evolving credentialing standards and internal process updates.
• • Assist in administrative audits and other tasks assigned by management, ensuring compliance and operational efficiency across the Medical Staff Services department.
• • Adapt to evolving responsibilities and emerging challenges in a fast-paced, remote healthcare environment while maintaining accuracy and attention to detail.
• • Ensure all documentation is stored, submitted, and shared in strict accordance with departmental workflows and confidentiality protocols.
• • Coordinate with internal stakeholders to confirm accuracy of provider data across all internal platforms and external partner systems.
• • Proactively identify and resolve gaps in credentialing documentation before deadlines to prevent delays in provider privileging.
• • Contribute to continuous improvement of privileging processes by offering feedback on workflow inefficiencies and recommending enhancements based on daily operations.