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Credentialing Specialist
Credentialing SpecialistPresbyterian Healthcare Services • Albuquerque, NM, United States
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Credentialing Specialist

Credentialing Specialist

Presbyterian Healthcare Services • Albuquerque, NM, United States
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Credentialing Specialist

Requisition ID

2025-47252

Category

Provider Services

Location : Name

Presbyterian Hospital

Location : City

Albuquerque

Location : State / Province

NM

Minimum Offer

USD $18.33 / Hr.

Maximum Offer for this position is up to

USD $27.25 / Hr.

Overview

Presbyterian is seeking a highly detail-oriented Credentialing Specialist to conduct comprehensive background investigations on physicians and healthcare providers seeking affiliation with our Albuquerque and regional facilities.

This is a Full Time (1.0 FTE) position - Exempt : No

  • Job is based at Presbyterian Hospital
  • Work hours : Days

Join our team and play a crucial role in maintaining the integrity and excellence of our medical staff.

Qualifications

  • High School Diploma
  • One (1) to three (3) years experience in hospital medical staff or managed care credentialing preferred.
  • Certification or eligibility for certification as a Current certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred.
  • Responsibilities

  • Analyze practitioner applications and / or requests to ensure that required documentation / information has been submitted in order to initiate the primary source verification processes
  • Conducts primary source verification of applicants' education, licensure, professional work history, medical malpractice history for the purpose of determining competency and eligibility to be awarded membership and / or privileges
  • Prepares processed files for review by appropriate members of medical staff leadership, including identification of information that may require additional investigation
  • Utilizes appropriate tracking tools for the purpose of ensuring timely completion of applications
  • Collects / analyzes data from various sources to include with initial and / or reappointment applications. Such data includes but is not limited to focused professional practice evaluations, ongoing professional practice evaluations, and privileging eligibility criteria
  • Process other credentialing requests, as assigned, in accordance with established policies and procedures
  • Responsible for on-boarding and / or orientation of new Medical Staff members, according to established policies and procedures
  • Benefits

    About Presbyterian Healthcare Services

    Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.

    The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities-like challenges, webinars, and screenings-with opportunities to earn gift cards and other incentives.

    As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships.

    Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.

    AA / EOE / VET / DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

    Maximum Offer for this position is up to

    USD $27.25 / Hr.

    Compensation Disclaimer

    The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

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