Skip to main content

Credentialing Specialist

CHI Memorial Chattanooga Chattanooga, Tennessee
Apply

The posted compensation range of $19.68 - $27.06 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Requisition ID 2025-393352 Employment Type Full Time Department Credentialing Hours/Pay Period 80 Shift Day Weekly Schedule Days Remote No Category Management
Overview

CHI Memorial Hospital now part of CommonSpirit Health formed between Catholic Health Initiatives (CHI) and Dignity Health is once again the only hospital in the Chattanooga area to be named a Best Regional Hospital by U.S. News & World Report. We are proud to be the regional referral center of choice providing health care throughout Southeast Tennessee and North Georgia. We offer the following benefits to support you and your family: On-site childcare with extended hours Care@Work premium account for additional support with children pets dependent adults and household needs Employee Assistance Program (EAP) for you and your family Paid Time Off (PTO) Health/Dental/Vision Insurance Flexible spending accounts Voluntary Protection: Group Accident Critical Illness and Identify Theft Adoption Assistance Tuition Assistance for career growth and development Matching 401(k) and 457(b) Retirement Programs Wellness Program Additional incentives for eligible full time day shift and night shift opportunities


Responsibilities

Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process. Facilitates all aspects of CHI Health System credentialing and CHI Health Credentialing Verification Organization.  This includes initial appointment, reappointment, expirables process, as well as clinical privileging for Medical Staff and Advanced Practice Clinicians. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. Responsible for the accuracy and integrity of the credentialing database system and related applications.

Essential Key Job Responsibilities

  1. Reviews practitioner applications and accompanying documents, ensuring applicant eligibility.
  2. Conducts thorough background investigation, research and primary source verification of all components of the application file.
  3. Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
  4. Prepares credentials file for completion and forwards all information to the applicable entities ensuring file completion within time periods specified.
  5. Processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.
  6. Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
  7. Assists with managed care delegated credentialing audits.
  8. Utilizes the Medical Staff credentialing database, optimizing efficiency, and performs query, report and document generation.
  9. Monitors the initial, reappointment and expirables process for all medical staff, APC staff,  and delegated providers, ensuring compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS, federal and state), as well as Medical Staff Bylaws, Rules and Regulations, policies and procedures, and delegated contracts.

Qualifications
  • High School diploma or equivalent required
  • Ability to communicate effectively, both orally and in writing.
  • Program planning and implementation skills.
  • Knowledge of related accreditation and certification requirements.
  • Knowledge of medical credentialing and privileging procedures and standards.
  • Ability to analyze, interpret and draw inferences from research findings, and prepare reports.
  • Working knowledge of clinical and/or hospital operations and procedures.
  • Informational research skills.
  • Ability to use independent judgment to manage and impart confidential information.
  • Database management skills including querying, reporting, and document generation.
  • Ability to make administrative/procedural decisions and judgments.
Apply

Map this location

Get an idea of what your daily routine can be like.

Click Here >

Join our Talent Community so you can stay connected and be alerted to future opportunities.

Sign Up

No recently viewed jobs

You have no saved Jobs

Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.