Credentialing Analyst

HH MedStar Health Inc.•Baltimore, MD

56d•$23 - $41

About The Position

Under the direction of the System Director responsible for the administrative duties required in the credentialing primary source verification process. Imports enters and maintains specialized applicant information into a complex database and coordinates the credentialing and primary source verification process for the Medical Staff offices of the respective MSH entities. Ensures the credentialing and primary source verification process complies with organizational as well as an accrediting agency Federal and State regulatory standards. Works in a team environment within the department and with the Medical Staff offices. Serves as a liaison between MSH-affiliated hospitals and Medical Staff Administration offices MMG and MedStar Family Choice.

Responsibilities

Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
Tracks initial/re-credentialing application sent received and in-process.
In accordance with established policies & procedures and time frames takes action on non-returned applications.
Conducts primary source verification for all initial/re-credentialing applications in accordance with defined workflows and established policies and procedures.
Responsible for tracking all queries and performing subsequent queries or determining the need for another means of verification (other than routine form letter) in accordance with deadlines and priorities.
Responsible for the follow-up on missing data and/or discrepancies in accordance with established time frames and based on knowledge of general credential processes and needs of the clinical assignment.
As responses to queries received and information entered in database compares information received with the information provided by the applicant to ensure accuracy and completeness.
Responsible for the completion of the verification process within established time frames to ensure the entity has time to complete entity-specific committee reviews prior to appointment/next reappointment date.
Imports all reapplications from the online application portal in accordance with the CVO policy for data standardization.
Maintains integrity of the credentialing database and all practitioner records. Utilizes appropriate database tracking reports to ensure accuracy and thoroughness of imported data as well as data that may be entered manually.
Serves as a liaison with MSH affiliates and their medical staff administration departments MMG and MFC which includes providing effective and timely communication as the status of the application and any issues that may be identified.
May process initial/re-credentialing applications for those applications that have been deemed