Conducts background investigations on physicians and other providers applying for affiliation including licensure, education and post-graduate clinical training, board certification, disciplinary actions and other professional sanctions, malpractice history, and peer assessment of current competence.
Reviews and analyzes physician applications and credentialing documents including certificates of education, residency and fellowship training, board certification and eligibility, licensure, professional work history, liability insurance and malpractice history.
Assesses completeness of information and providers' qualifications relative to established standards.
Reviews and analyzes primary source verification for licensure, certification or registration required to practice a profession.
Requests, maintains, and ensures competency data is present at appointment and re-appointment.
Maintains tracking of all new provider s drug screening, background checks, child abuse clearance, finger printing, code of conduct, disruptive practitioner policies, current clinical competency data and Health Service information for new providers.
Maintains a working knowledge of applicable regulatory agencies.
Maintains an understanding of the third party payor requirements.
Identifies and flags adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for credentialing review.
Prepares, mails letters and tracks responses.
Employs public relations skills in a wide variety of phone contacts with external sources for purposes of soliciting information essential to credentials investigations, including licensing agencies; university and hospital training program administrators; certification boards; liability insurance carriers; hospital officials and credentials staff; and physicians and their office staffs.
Organizes and maintains physician files and information following confidentiality guidelines, performs varied clerical support functions.
Internally audits and maintains physician files in accordance with established principles of legal documentation and confidentiality.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
High School Diploma or Equivalent (GED)- (Required)
Minimum of 2 years-Healthcare (Required)
Certification(s) and License(s)
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh FoodFarmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencingprograms, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13... hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers. What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.