Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Being a Medical Staff Credentialing Director maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Additionally, Medical Staff Credentialing Director analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
The Credentialing Specialist is responsible for assisting in all aspects of the licensing and credentialing of the Company. The Specialist will process applications on behalf of the Company in order to ensure compliance and completeness of licenses and agreements with Medicare, state Medicaid agencies, federal, state and local licensing agencies and private health insurance companies.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Include the following as well as other duties and responsibilities, which may be assigned.
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily and must possess the ability to: interact professionally and ethically with team members, all levels of management, government agencies and commercial payer personal; handle multiple tasks simultaneously; provide clear, concise oral and written directives/communications; quickly assess situations and respond appropriately; handle special requests in a sensitive, professional manner. Strong attention to detail and follow through is required. Meticulous organization and filing skills. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
QUALIFICATION REQUIREMENTS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION AND/OR EXPERIENCE:
TRAINING:
Our industry is a highly regulated industry, and because of that and our commitment to providing the best in class products, services, and support, we require ALL employees to complete the following training programs prior to the marketing and promotion of our products, services, and support systems:
CONTINUING EDUCATION:
To continue to be best in class within our industry, we require all employees to participate in ongoing education to maintain / increase their competency or in the event the team member changes responsibility within the company.
Notice:
Employment with the Company is “at will.” This means a team member or the Company may end a team member’s employment at any time with or without reason. None of the Company’s policies, procedures, or practices, including those set forth on the Company Website and/or Intranet, are to be viewed as creating any promises or contractual rights. They are guidelines that the Company may, at its discretion, change at any time without prior notice to any team member. The information contained in this policy replaces all previous handbooks and other statements of Company policies, rules, and procedures.
Clear All
0 Medical Staff Credentialing Director jobs found in Melbourne, FL area