Clerical - Credentialing - All Medical Personnel

Position: Credentialing Specialist

Job Description:
Under general supervision responsible for all functions relating to the credentialing and re-credentialing of practitioner applicants.

Data entry data collection and verification of credentials from primary source and analyzes information collected for presentation to medical staff leadership.

Responsible for verifications for medical staff and allied health professionals' initial appointments provisional reviews reappointments and privilege delineation

Coordinates the processing of applications. Assure all applications are processed completely and in a timely manner

Verifies required primary source credentialing documentation to ensure medical staff and allied health professional files are current and policies and procedures have been followed to obtain required documentation and verification

Coordinates activities and explains procedure to facilitate the reappointment process

Request confidential information such as case logs procedures and other sensitive matters

Tracks responses and follows-up on items not received within established time frames Maintains credentialing software database by ensuring that data entered is complete and accurate

Submit completed files to MSO offices and delegated entities

Acts as a liaison between Henry Ford Health System facilities and the CCS.

Communicates with internal and external customers in a clear concise manner to obtain or provide necessary information

Assist in compliance with the accrediting and regulatory agencies

Improves professional growth knowledge of job to maintain efficiency and effectiveness of the CCS by participating in professional organizations attending seminars and reading journals and publications addressing medical staff services activities and trends

Participates in system integration and continuing quality improvement efforts

Receives evaluates and answers customer inquiries and provides customer support in accordance with corporate standards of excellence.

Performs other duties as required which are subject to change at the discretion of management.Qualifications:

2 Years of Prime Source Credentialing Experience - Required

MUST have 1 Years of Hospital Credentialing Experience outpatient/clinic experience does not apply- Required

MUST be proficient with using MDStaff Credentialing Software - Required

End-to-end provider Credentialing Experience MDs amp DOs - Required

Working knowledge of State and Federal law relating to due process and provisions of the Health Insurance Portability and Accountability Act of 1996 and all applicable standards.

Must be able to work independently in a fast-paced environment

Please reference Job number: 181920