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)
Position Highlights :
About Firelands Health :
Our goal at Firelands Health is to be the best & preferred independent healthcare employer for the Sandusky Bay region.
Firelands Health is the area’s largest and most comprehensive resource for quality medical care. We are big enough to care for you, and small enough to care about you .
We are locally managed and governed as a not-for-profit healthcare facility, serving the counties of Erie, Ottawa, Sandusky, and Huron, covering a regional service area with over 300,000 residents.
Our mission is to provide excellent healthcare, promote community wellness, and improve the lives we serve.
Our Core ACE Values : Attitude : We choose to be positive and inclusive every day. Commitment : We are committed to exceed the expectations of those we serve.
Enthusiasm : We will work passionately to make a difference.
What you will do :
To include but not limited to, credentialing / recredentialing with Medicare, Medicaid, Anthem, MMOH, other major insurance payors and CAQH.
Insurance :
Credential locations when the facility obtains a new contracted payor.
Add or delete locations as needed.
Answers telephones and screens and routes calls in a professional manner; records and delivers messages promptly and accurately.
Uses own initiative in the development of appropriate forms, procedures, etc.
Utilizes computer equipment maintaining current working knowledge of multiple programs including Outlook, Word, Excel, and PowerPoint.
Participates in department performance improvement activities as assigned and attends required training.
Demonstrates Service Excellence and ACE.
Available for special projects as needed and performs other duties, as assigned.
What you will need :
Last updated : 2024-04-11