System Credentialing Spec SNE

Munson Healthcare•Traverse City, MI

About The Position

A Day in the Life Serves as the central contact for all medical staff applications for incoming MHC providers for staff privileges or reappointment, as outlined in the Central Credentials Verification Policies and Procedures, closely monitoring information collection, cognitive analysis of all information received. Evaluates adequacy and quality of information. Responsible for processing provider application, running primary source verifications, completing background checks, and other database queries as appropriate. Works with recruitment, payer enrollment, local medical staff contacts, as well as ambulatory practice staff and leadership to ensure accurate, complete and timely file completion. Responsible for verifying all information garnered through investigation and follow up processes, maintaining HIPAA and regulatory compliance, while adhering to Joint Commission standards, CMS guidelines, and other regulatory bodies at all times.

Requirements

Bachelor's degree or equivalent experience required
Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella.
MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption.

Nice To Haves

2 years experience in Medical staff/physician services, hospital credentialing, payer enrollment, or related field preferred.
Certified Professional Credentialing Specialist (CPCS) - Certification or eligibility/willingness to certify as a Certified Professional Credentialing Specialist (CPCS) within 3 years of hire preferred.

Responsibilities

Serves as the central contact for all medical staff applications for incoming MHC providers for staff privileges or reappointment, as outlined in the Central Credentials Verification Policies and Procedures, closely monitoring information collection, cognitive analysis of all information received.
Evaluates adequacy and quality of information.
Responsible for processing provider application, running primary source verifications, completing background checks, and other database queries as appropriate.
Works with recruitment, payer enrollment, local medical staff contacts, as well as ambulatory practice staff and leadership to ensure accurate, complete and timely file completion.
Responsible for verifying all information garnered through investigation and follow up processes, maintaining HIPAA and regulatory compliance, while adhering to Joint Commission standards, CMS guidelines, and other regulatory bodies at all times.