Medical Staff Credentialing Supervisor oversees day-to-day activities of staff that process credentialing and recredentialing applications for health care providers. Implements department procedures to facilitate organized and up-to-date provider databases. Being a Medical Staff Credentialing Supervisor administers system for tracking license and certification expirations to ensure renewals are submitted in a timely fashion. Ensures that applications are properly verified and accurately uploaded into an online credentialing database system. Additionally, Medical Staff Credentialing Supervisor resolves complex questions regarding credentialing or provider database maintenance and best practices. Prepares reports on applications and credentialing status to identify trends and improve the credentialing process. May require a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a manager. The Medical Staff Credentialing Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be a Medical Staff Credentialing Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)
Administrator Managed Care Credentialing
I. Position Responsibilities
II. Customer Service
III. Health and Safety
POSITION QUALIFICATIONS:
Education and Training: Bachelor’s Degree
Experience: 3 plus years of experience in a credentialing role as a Provider or in a Managed Care Organization Credentialing Position or with a Certified Verification Organization
Knowledge, Skills, and Abilities:
PHYSICAL DEMANDS: See attached Job Activity Requirements
WORKING CONDITIONS: Working generally indoors in well-lighted, well-ventilated areas. Working conditions as in hospital surroundings. The position will be working from home and need to work regular business hours of 8am to 5pm est.
ORGANIZATIONAL DATA: This is an exempt position, supervised by the SVP of Managed Care.
The above statements are intended to describe the general nature and level of the work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skill required of personnel so classified.
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