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Job Information

Randstad Credentialing Coordinator and Policy Coordinator in Somerville, Massachusetts

Credentialing Coordinator and Policy Coordinator

job details:

  • location:Somerville, MA

  • salary:$16 - $29 per hour

  • date posted:Monday, June 24, 2019

  • experience:Experienced

  • job type:Temp to Perm

  • industry:Insurance Carriers

  • reference:S_773057

  • questions:tracey.doubrava@randstadusa.com857-282-7510

job description

Credentialing Coordinator and Policy Coordinator

The Credentialing and Policy Coordinator for Spaulding Rehabilitation Network facilitates all aspects of credentialing, including initial appointment, reappointment, expirable process, as well as clinical privileging for Medical Staff, Advanced Practice Nurses, Allied Health Practitioners and other providers outlined in the Hospitals' and Skilled Nursing Facilities' By-Laws, policies, or related contracts. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statutes and laws related to credentialing. Responsible for the accuracy and integrity of the credentialing database system and related applications. Works under the supervision of the Credentialing Manager.

Responsibilities:

? Coordinate and monitor the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.

? Process initial and reappointment applications assisting applicants with their questions.

? Conduct thorough background investigation and primary source verification of all components of the application file.

? Identify issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.

? Prepare credentials files for completion and presentation to the Medical Staff Committees, ensuring file completion within time periods specified.

? Process requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.

? Respond to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.

? Assist with conducting internal files audit.

? Utilize the MSOW credentialing database, optimizing efficiency, and submits and retrieves National Practitioner Database reports in accordance with Health Care Quality Improvement Act.

? Handle Credentialing Office?s mail, files, and orders office supplies.

? Enter new practitioners in Meditech provider dictionary.

? Process EChecks requests and other invoices for various organizations in PeopleSoft.

? Assist with preparing Credentialing Committees meeting agendas, attends the Committee meetings, and takes meeting minutes.

? Notifiy new staff members of the appointment and privileges granted to them.

? Provide administrative support to the Credentialing Manager.

? Perform miscellaneous job-related duties as assigned.

? Serve as point person for the policy conversion project.

Working hours: 8:30 AM - 5:00 PM

Skills:

--At least two years' experience in comparable position within a medical staff office, medical records department or other health-care related office.

--Knowledge of medical terminology preferred.

--Must have good organizational skills, attention to details.

--Adhere to and maintain rigid confidentiality status.

--Must be knowledgeable of, or have the ability to learn to use menu-driven computerized systems. Have the ability to use and/or learn to use Microsoft products such as Word, Excel, and Outlook. Experience with MSOW credentialing software is ideal.

--Possess the ability to organize and handle multiple tasks under pressure, particularly during periods when conflicting projects and/or time tables coincide.

--Must communicate in writing and speaking professionally and effectively.

Education:

High School

Experience:

Experienced

Qualifications:

? Certified Provider Credentialing Specialist (CPCS) certification is preferred. Willingness to participate in continued professional development and eventual CPCS certification is required.

Required: High School Graduate

Preferred: College credit in health information, medical staff services or related field, desirable.

Please send resume to: tracey.doubrava@randstadusa.com

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