Quality Assurance Credentialing Specialist I (WFH) in Nashville, TN at Parallon

Date Posted: 4/3/2018

Job Snapshot

Job Description

Parallon believes that organizations that continuously learn and improve will thrive. That’s why after more than a decade Parallon remains dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.
 
Job Summary
This position will be responsible for undertaking quality assurance monitoring of regional credentialing services. Excellent communication, high integrity, ability to work with sensitive information, and relationship building skills are required. As requested, may be expected to assist with other tasks/projects. Compliance with HCA policy and procedure, Federal and State regulatory, and accrediting agencies is required.
 
Key Responsibilities
  • Efficiently navigate within HCA’s centralized credentialing database (Cactus) to be able to analyze data and images
  • Detailed knowledge of HCA’s centralized credentialing policies and procedures to assure that services provided are in compliance
  • Detailed  knowledge  of  HCA’s  flagging  process  to  assure  that  flags  are  thoroughly documented and escalations are tracked accurately.
  • Ability to work with multiple computer monitors to analyze credentialing forms, data, and images and accurately enter quality assurance statistics into standard quality assurance database tool.
  • Compliance with HCA policy and procedures, Federal and State regulatory and accrediting agencies as required.
  • Practice  and  adhere  to  the  “Code  of  Conduct”  philosophy  and  “Mission  and  Value Statement



Job Requirements

  • Bachelor Degree preferred
  • Minimum one-year experience in healthcare credentialing (i.e., healthcare facility, managed care setting, credentials verification organization, or Medical Staff Office) preferred
  • Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance preferred
  • Able to work without daily supervision (monitoring through reporting and supervising through use of technology)