
Description
General Summary of Position
Under the direction of the System Director, serves as a team lead for the credentialing analysts in performing administrative functions of the Centralized Verification Office and provides ongoing educational support to the credentialing analysts. Imports and maintains accurate specialized applicant information into a complex database and coordinates the initial and re-credentialing process for the Medical Staff offices of the respective MSH entities and MMG site-based providers. Ensures the credentialing/primary source verification process complies with organizational as well as an accrediting agency, Federal, and State regulatory standards. Responsible for the audit and compliance of all credentialing files, which includes management of credentialing information, coordination of correspondence, and interaction with practitioners and external organizations. Serves as a liaison between MSH-affiliated hospitals and Medical Staff Administration offices, MMG, and MedStar Family Choice.
Primary Duties and Responsibilities
Minimum Qualifications
Education
- High School Diploma or GED required
- Associate's degree preferred
Experience
- 3-4 years Experience in credentialing required
Licenses and Certifications
- Certified Provider Credentialing Specialist (CPCS) within 1 Year required or
- CPMSM - Certified Professional Medical Services Management within 1 Year required
Knowledge, Skills, and Abilities
- Working knowledge of general office practices and software applications (MS Office) and database management.
- Demonstrated understanding of credentialing policies and procedures and training program requirements as established by the CVO, as well as accreditation and regulatory requirements relating to the medical staff, specifically Joint Commission and NCQA.
- Organizational skills are required to handle the voluminous influx of credentialing applications and to prioritize tasks in order to meet cyclical deadlines.
- Ability to manage demanding workload; self-motivated; able to carry out responsibilities with minimum supervision.
- Analytical skills are necessary to determine whether correct and complete information was provided on applications.
- Meticulous attention to detail.
- Ability to analyze problems and offer solutions; able to anticipate problems and act proactively to resolve or minimize them.
- Interacts with diverse groups of people within the Health System and with outside agencies.
- Possesses the ability to manage specialized databases, including the production of reports covering the area of responsibility.
- Understands the perspectives of both credentialing professionals and leadership; shares perspectives with team members and leadership.
- Adheres to professional confidentiality standards in accordance with legal, ethical, and departmental policies. Handles sensitive and confidential situations/information, with a high degree of tact and diplomacy.
- Effective interpersonal skills and demonstrated written and verbal communication skills are necessary to interact with providers and both external and internal customers.
- Possesses excellent command of English; verbal, written (to include grammar and spelling), and reading comprehension.
- Exhibits excellent interpersonal skills, including those required for customer service.
This position has a hiring range of $28.2 - $47.3
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