What are the responsibilities and job description for the ADMINISTRATIVE - CREDENTIALING SPECIALIST (DAYS) DETROIT position at Raisso?
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.
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
