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Job Summary and Responsibilities

_This is a hybrid position_

Performs the provider credentialing and database maintenance processes based on department and organizational policy, procedure, and standards and guidelines set forth by The Joint Commission (TJC) and the National Committee for Quality Assurance (NCQA), URAC, State and Federal Government, and health plan payors. Incumbents are responsible for: 1) ensuring accurate and timely credentialing and subsequent submission of provider information to support appointing and claims submission; 2) ensuring accurate and timely data entry of provider demographics; and 3) performing as the point of contact for internal stakeholders, vendors and providers.

Incumbents are also accountable for: 1) remaining current on federal and state regulatory, licensure, certification and application requirements to include Medicare, DSHS, Federal and State L&I, NPDB, and HCQIA standards; 2) Remaining current on payer requirements and credentialing processes to include a working knowledge of TJC, NCQA and URAC accreditation standards and CMS guidelines; 3) maintaining professional and proactive relationships with providers, contracted payers, and stakeholders, including troubleshooting and responding to inquiries related to credentialing and/or privileging; and 4) contribute to policies and procedure updates, internal desktop procedures and workflows.

Job Requirements

Experience:

Two (2) years practitioner credentialing experience required _or_ three (3) years administrative experience, that demonstrates attainment of the requisite job knowledge skills/abilities _and_ three (3) years administrative experience, that demonstrates attainment of the requisite job knowledge skills/abilities, preferably in a healthcare setting.

Certifications:

Certified Provider Credentialing Specialist (CPCS) - preferred.

Where You'll Work

Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area.

Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person – body, mind, and spirit – in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth.

Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care.

We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose.

Pay Range

$26.06 - $36.81 /hour

We are an equal opportunity/affirmative action employer.