Medical Staff Credentialing Manager manages staff that process credentialing and recredentialing applications for health care providers. Oversees department operations to ensure compliance with all regulatory standards. Being a Medical Staff Credentialing Manager implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Analyzes reports on applications and credentialing status to identify trends and improve the credentialing process. Additionally, Medical Staff Credentialing Manager prepares files for 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 a director. The Medical Staff Credentialing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Medical Staff Credentialing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (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
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