SUNCOAST COMMUNITY HEALTH CENTERS, INC. POSITION DESCRIPTION

POSITION TITLE: Credentialing Specialist FSLA: NON-EXEMPT

Under the general direction of the Chief Financial Officer and the direct supervision of the Billing Manager, incumbent is responsible for recording, analyzing, organizing, storing and maintaining incoming documents and verifying credentials of providers.

KNOWLEDGE, SKILLS & ABILITIES REQUIRED: 1. Associate’s degree or minimum four years of experience in a related position. 2. Knowledge of Microsoft Office applications including Word, Excel and PowerPoint. 3. Possess a clear understanding of credentialing process 4. Prioritizes work duties and plans work schedule accordingly. 5. Knowledge of Healthcare and/or community Health Center industry and practices 6. Superior level of professionalism, communication and interpersonal skills. 7. CPR required. 8. Ability to manage multiple priorities ______PRINCIPLE DUTIES: 1. Responsible for recording, analyzing, organizing, storing and maintaining incoming documents and information from HR and provider offices. 2. Preliminary credentials verification upon receipt of credentialing or re-credentialing applications and accompanying documentation 3. Performs primary source verification 4. Reviews credentialing application for completeness and accuracy 5. Prepares for and attends Credentials Committee Meeting 6. Queries necessary sources to verify information on applications 7. Reviews CV and verifies there are no gaps in medical school/work history. 8. Is knowledgeable about and responds to questions regarding departmental operations, policies and procedures. 9. Maintains accurate and up to date credentialing provider files 10. Data entry into credentialing database as needed (CAQH) 11. Processes and maintains application for admitting privileges to TGH. 12. Preparing and maintaining up-to-date reports and summaries for AAACH accreditation 13. Meets all federal and state guidelines when processing applications 14. Re-credentials providers every two years. 15. Other duties as assigned

Acknowledged: ______Date: ______(Employee)

Discussed with Incumbent: ______Date: ______(Supervisor)