Lead Credentialing Specialist

Lead Credentialing Specialist
Job No: 496564
Department: Medical Board
Local Title: Lead Credentialing Specialist
Budget Title: Teaching Hospital Staff Assistant I
Work Type: Full Time
Location: Brooklyn, NY
Categories: Management and Professional, Administrative
Are you looking to take your career to new heights with a leader in healthcare? SUNY Downstate Health Sciences University is one of the nation's leading metropolitan medical centers. As the only academic medical center in Brooklyn, we serve a large population that is among the most diverse in the world. We are also highly-ranked by Castle Connolly Medical, a healthcare rating company for consumers, among the top 5 leading U.S. medical schools for training doctors.
Bargaining Unit:
UUP
Job Summary:
The Medical Board Office at SUNY Downstate Health Sciences University is seeking a full-time TH Staff Assistant 1 / Lead Credentialing Specialist. The successful candidate will:

• Process applications for initial appointments and reappointments as assigned, within 60 days, and in compliance with Bylaws, P&P, NCQA, CME, Joint Commission Standards and other state and federal regulations.
• Collect and analyze primary source verifications of credentials, education, and training for potential compliance issues and generates follow-up requests for additional information if necessary &/or requested.
• Assemble and prepare credentialing files for review by the Director, Clinical Department Chairs/Chiefs and Creds Committee and Medical Executive Committee.
• Perform accurate data entry to credentialing software and assists with the database management.
• Track, monitor, and update expired credentials and information to ensure that accurate and current data exist for each practitioner maintained in the database and those provider's licenses and certifications remain current.
• Maintain and apply working knowledge of the credentialing requirements & standards of CMS and NY State law relating to credentialing, privileging, and the medical staff organization, the Joint Commission and NCQA.
• Coordinate and support meetings of the Credentials Committee, Medical Executive Committee, or the Medical Staff and coordinates follow up from meetings to assure that action is taken, referrals are timely, and notifications to individuals as necessary is completed.
• Assist with reviewing and preparing credential files to ensure compliance for Managed Care audits, site visits, and accreditation surveys.
• Process requests for verifications of hospital affiliations (2805s) to respond within 45 days of the date of requests.
• Support the Medical Board administrative functions (answering phones, reception, filing, scanning, audit preparations, mailings)
• Perform quality review of initials and reappointments and provide feedback on findings to the credentialing staff
• Participate in training and orienting new staff to the Medical Staff Office
• Support Director of Medical Staff Offices and provides leadership coverage when director is out.
• Perform other duties as assigned and assists in special projects as needed to meet department and/or system needs.

Required Qualifications:

• Bachelor's Degree and 2 years of medical credentialing experience;
  • OR a combination of education and related work experience
• Ability to handle large work volume independently in a high paced environment.
• Excellent oral and written communication skills, excellent customer service skills and detail-oriented.

Preferred Qualifications:

• Certified Provider Credentialing Specialist or Certified Professional Medical Services Management

Work Schedule:
Monday to Friday; 8:30am to 4:30pm (Full-Time)
Salary Grade/Rank:
SL-2
S alary Range:
Commensurate with experience and qualifications
E xecutive Order:
Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor's Office of Employee Relations at (518) 474-6988 or via email at
Equal Employment Opportunity Statement:
SUNY Downstate Health Sciences University is an affirmative action, equal opportunity employer and does not discriminate on the basis of race, color, national origin, religion, creed, age, disability, sex, gender identity or expression, sexual orientation, familial status, pregnancy, predisposing genetic characteristics, military status, domestic violence victim status, criminal conviction, and all other protected classes under federal or state laws.
Women, minorities, veterans, individuals with disabilities and members of underrepresented groups are encouraged to apply.
If you are an individual with a disability and need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please contact Human Resources at
Advertised: October 09, 2024 Eastern Daylight Time
Applications close: