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Primary Source Verification Specialist

Position:

Primary Source Verification Specialist

Reports to:

Director of Medical Staff Services

Summary

As a Primary Source Verification Specialist, you will be a vital member of our healthcare team, specializing in verifying the credentials of neurology professionals. Your primary role involves conducting meticulous primary source verifications to ensure the accuracy and legitimacy of the qualifications held by providers, completing and maintaining the electronic records, assisting the privileging team with other miscellaneous requests. This position demands a keen understanding of the unique credentials and requirements within the field of neurology, as well as adherence to regulatory standards.

  • Scrutinize and assess documentation submitted by neurology professionals to ensure completeness, accuracy, and authenticity.
  • Conduct thorough verifications of providers’ professional licenses, board certifications, and other relevant credentials through direct communication with licensing bodies and certification boards or equivalent source, in accordance with the Primary Source Verification Policy.
  • Collaborate with hospitals, clinics, and other medical institutions to obtain and verify information related to providers’ training, education, and professional experience or equivalent source, in accordance with the Primary Source Verification Policy.
  • Cross-reference information obtained from primary sources with documents provided by providers to identify any discrepancies.
  • Establish effective communication channels with providers, medical staff, and relevant institutions to facilitate the verification process.
  • Ensure that all credentialing activities comply with relevant healthcare regulations and standards and company policies.
  • Build and maintain accurate and up-to-date records in the credentialing database, ensuring that the documents meet both regulatory and departmental needs, and documenting the status of each verification process.
  • Efficiently manage multiple neurology credential verifications simultaneously, ensuring deadlines are met, including by not limited to, NIHSS Certifications, CMEs, affiliation verifications, licensure verifications, and collaborative agreements.
  • Put complete verification packets together and present to C/L Director for review, noting any red flags for internal applicants upon initial appointment and reappointment.
  • Put complete verification packets together, as outlined in the Proxy Agreement, for Privileging Specialists to submit.
  • Maintain current documentation on all providers.
  • Request references on all providers in accordance with PSV policy.
  • Create abbreviated CVs to use in the Credentialing and Licensing process.
  • Facilitate requests for CAQH, NPPES, and PECOS
  • Facilitate all signatures for facility provider enrollment requests.
  • Other administrative duties as assigned.

Qualifications

  • High school diploma or equivalent (GED) is required.
  • Previous experience in a healthcare setting, administrative role, or a related field is preferred.
  • Strong communication skills, both written and verbal, are crucial. Healthcare credentialing often involves interacting with various professionals, including physicians, administrators, and regulatory bodies.
  • Healthcare credentialing requires a high level of accuracy and attention to detail. Ensuring that documents are complete, accurate, and in compliance with regulations is a key aspect of the role.
  • Proficiency in using Microsoft Office products and Google products.
  • Good customer service skills are important, as the role may involve interacting with healthcare providers and staff to gather necessary information and resolve issues.
  • The healthcare industry is dynamic, and credentialing processes may change. Being adaptable and open to learning new regulations and procedures is important.
  • Maintaining a professional demeanor and handling sensitive information with confidentiality is crucial in healthcare credentialing.

Important: When applying for entry-level positions, focus on highlighting any relevant education, certifications, and experience you may have, even if it’s not directly related to healthcare credentialing. Emphasize transferable skills, such as organizational abilities, attention to detail, and communication skills, that can make you a strong candidate for the position.

Your Details

Position Details

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