Job Description

Under general supervision, responsible for all functions relating to the credentialing and re-credentialing of practitioner applicants. Responsibilities include data entry, data collection, and verification of credentials from primary source and analyzes information collected for presentation to medical staff leadership. Responsible for verifications for medical staff and allied health professionals' initial appointments, provisional reviews, reappointments, and privilege delineation; a. Coordinates the processing of applications. Assure all applications are processed completely and in a timely manner; b. Verifies required primary source credentialing documentation to ensure medical staff and allied health professional files are current and policies and procedures have been followed to obtain required documentation and verification; c. Coordinates activities and explains procedure to facilitate the reappointment process; d. Request confidential information such as case logs, procedures and other sensitive matters; e. Tracks responses and follows-up on items not received within established time frames; Maintains credentialing software database by ensuring that data entered is complete and accurate; Submit completed files to MSO offices and delegated entities; Acts as a liaison between Henry Ford Health System facilities and the CCS. Communicates with internal and external customers in a clear, concise manner to obtain or provide necessary information; Assist in compliance with the accrediting and regulatory agencies (i.e. The Joint Commission, NCQA, URAC, HFAP) in regards to credentialing while developing and maintaining a working knowledge of the statutes and laws; Improves professional growth, knowledge of job to maintain efficiency and effectiveness of the CCS by participating in professional organizations, attending seminars and reading journals and publications addressing medical staff services activities and trends; Participates in system integration and continuing quality improvement efforts; Receives, evaluates and answers customer inquiries and provides customer support in accordance with corporate standards of excellence; Performs other duties as required which are subject to change at the discretion of management.

SUBMISSION REQUIREMENTS

2+ Years of Prime Source Credentialing Experience - Required MUST have 1+ Years of Hospital Credentialing Experience (outpatient/clinic experience does not apply)- Required MUST be proficient with using MDStaff Credentialing Software - Required End-to-end provider Credentialing Experience (MDs & DOs) - Required Working knowledge of State and Federal law relating to due process and provisions of the Health Insurance Portability and Accountability Act of 1996 and all applicable standards. Must be able to work independently in a fast-paced environment Can be onsite or remote (must live near Detroit - will be required to pick up equipment and briefly orient onsite) Must be able to work full-time hours All RTO Requests, scheduling conflicts, etc. must be provided at the time of submittal Must have access to a router in close proximity to a plug to set up the computer and ethernet Candidate must have excellent organization skills and be able to hit the ground running with minimal training. The expectation is to have 2-6 files completed daily. The candidate will start the assignment with 40 files to manage.

ABOUT THE FACILITY

Serving communities across Michigan and beyond, Henry Ford Health is committed to partnering with patients and members along their entire health journey. Henry Ford Health provides a full continuum of services - from primary and preventative care, to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care, and other healthcare retail. It is one of the nation's leading academic medical centers, recognized for clinical excellence in cancer care, cardiology and cardiovascular surgery, neurology and neurosurgery, orthopedics and sports medicine, and multi-organ transplants. Consistently ranked among the top five NIH-funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of health professionals, Henry Ford Health trains more than 4,000 medical students, residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan's largest and most diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network. The health system is led by President and CEO Robert G. Riney and serves a growing number of customers across 250+ locations throughout Michigan including five acute care hospitals, two destination facilities for complex cancer and orthopedics and sports medicine care, three behavioral health facilities, primary care and urgent care centers. Further Henry Ford Specifics: OT billed at 1.5x Bill Rate Raisso

Job Tags

Full time,

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