Government Credentialing Specialist

Job Description
The Government Credentialing Specialist reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
Responsibilities:
Initiate, verify, examine, and maintain the confidential credentials process for all professional applicants to NM (physicians, psychologists, advanced practice nurses, physician assistants, and designated clinical fellows).
Examine application for completeness and all required documentation.
Examine information reported for missing data elements.
Conduct follow-up with applicant on identified adverse elements.
Identify key issues in core credentials data.
Report identified adverse information and unresolved questions to credentials compliance coordinator.
Identify all practice locations for each applicant for his/her lifetime work history.
Determine when investigation and credentials process is complete by comparing and contrasting file to requirements and verifying that all documentation meets standards.
Identify and flag time-sensitive items for reverification.
Generate profile and reports.
Submit recommendation for final follow-up to the lead credentialing specialist and/or manager prior to administrative review process.
Maintain accurate and current credentials database for all applicants.
Record all credentials information immediately upon receipt.
Monitor and track application status and credentials process.
At all times, any department staff member must be able to access an applicants electronic record and determine current status.
Provide first contact and customer service to professional applicants and NU/NMG credentialing staff.