Senior Fiscal Specialist (Healthcare Credentialing) - Waukesha County

Waukesha County's Department of Health & Human Services is recruiting for a talented Senior Fiscal Specialist (Healthcare Credentialing). The Credentialing Senior Fiscal Specialist will organize, maintain, and verify all provider and practitioner credentials for privileging and insurance enrollment. They will track the expiration of certifications, maintain up to date files, and assist other staff and clients with inquiries. This position will serve as a subject matter expert on provider credentialing requirements, and will oversee the Credentialing process, agreements, and insurance provider requirements.

Essential Duties include:

• Processing initial credentialing and re-credentialing, privileging and insurance enrollment applications
• Collecting provider information from educational facilities, employers, government entities, applicant, their malpractice insurer, and other relevant sources
• Capturing primary source documentation and storing the information for reference
• Screening practitioner’s applications and documentation for red flags or discrepancies and notifying the proper stakeholders
• Work management and IT to set up providers correctly in the Electronic Healthcare Record for billing
• Presenting applications to the Credentialing Committee, Medical Advisory Committee, and Board
• Assist all parties with credentialing, privileging and insurance enrollment inquiries
• Audit sample files to ensure complete and accurate information is stored appropriately for Government and Legal audits
• Ensure compliance with all laws, regulations, procedures, and policies
• Complete projects for Credentialing, Privileging, and Enrollments
• Assist with continuous process improvements

Successful candidates will be familiar with supporting a medical staff business office, work well with a variety of stakeholders, and be able to handle ambiguity. The candidate must have excellent organizational, communication, analytical, problem solving, and technical skills. Candidates will enjoy variety, constant change, solving puzzles, and a team environment.

Waukesha County offers a comprehensive compensation and benefits package including excellent health/dental/vision, life insurance, generous paid time off (vacation, 10 holidays, 3 floating holidays, ample accrued sick time that rolls over each year), an exceptional pension plan with employer match and lifetime retirement payment plus an optional tax advantaged 457 retirement savings plan. Amongst many other benefits, employees are recognized and valued through a pay for performance system. Successful candidates will be eligible for performance-based merit increases and non-base performance awards. Employee well-being is promoted through a balanced work-life culture and through an exceptional employee wellness program that offers a variety of programs and tools to help promote an employee's wellness and health, including an on-site health & wellness clinic.

Prior to hiring, the successful candidate will be subject to work/education/certification reference(s) verification, a criminal background and driver's license check.