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Credentialing Coordinator
Milwaukee, WI
Job Description
Join our team who is committed to the delivery of the highest quality health care service. We are seeking a full-time Credentialing Coordinator that is self-motivated, energetic, and a take charge individual.
Responsibilities :
Process all initial and re-appointment applications for medical, behavioral, dental, and PT/OT staff appointments, clinical privileges, and hospital privileges to meet SSCHC policies and procedures, which are based on HRSA and Joint Commission standards. Process all initial and re-appointment applications for SSCHC and hospital credentialing and privileging. Prepare and maintain reports and summaries of credentialing activities such as accreditation, membership, or facility privileges. Prepare and execute attestations for Meaningful Use and maintain reports and summaries for MU. Prepare and assist in Audits for HRSA, Joint Commission, 340B, and Meaningful Use. Ensure that all information meets federal and state guidelines when processing applications. Work in collaboration with Providers and the Offices of the VP of Medical Affairs and VP of Behavioral Health to assist providers with maintenance of various required certifications, for example, licenses, Board certification, BLS certification, etc., as required for credentialing and privileging. Includes tracking expiration dates and providing regular reminders to Providers and their immediate supervisors of certifications that need to be renewed, understanding that the reminder system will be fluid as requirements change. Submit complete credentialing materials to the VP of Medical Affairs and VP of Human Resources for approval. Maintain up-to-date provider database utilizing credentialing software, including but not limited to provider licenses, BLS, employee health documents, professional liability insurance, hospital appointments and payor enrollments, and renewal period expiration dates. Enroll all billable providers in contracted Medicaid, Medicare, and Commercial Insurances and maintain provider credentialing and enrollment thereafter. Enroll all billable prescribers in 340B and maintain their database with SSCHC partner pharmacies. Function as the Administrator for all insurance websites/portals for registration and billing staff. Onboard providers with Greenway and maintain provider lists and invoices for payable Greenway services. Enroll prescribers in Electronic Prescription of Controlled Substances (EPCS) thru Greenway and provide support services for EPCS as needed.
Qualifications:
Responsibilities :
Process all initial and re-appointment applications for medical, behavioral, dental, and PT/OT staff appointments, clinical privileges, and hospital privileges to meet SSCHC policies and procedures, which are based on HRSA and Joint Commission standards. Process all initial and re-appointment applications for SSCHC and hospital credentialing and privileging. Prepare and maintain reports and summaries of credentialing activities such as accreditation, membership, or facility privileges. Prepare and execute attestations for Meaningful Use and maintain reports and summaries for MU. Prepare and assist in Audits for HRSA, Joint Commission, 340B, and Meaningful Use. Ensure that all information meets federal and state guidelines when processing applications. Work in collaboration with Providers and the Offices of the VP of Medical Affairs and VP of Behavioral Health to assist providers with maintenance of various required certifications, for example, licenses, Board certification, BLS certification, etc., as required for credentialing and privileging. Includes tracking expiration dates and providing regular reminders to Providers and their immediate supervisors of certifications that need to be renewed, understanding that the reminder system will be fluid as requirements change. Submit complete credentialing materials to the VP of Medical Affairs and VP of Human Resources for approval. Maintain up-to-date provider database utilizing credentialing software, including but not limited to provider licenses, BLS, employee health documents, professional liability insurance, hospital appointments and payor enrollments, and renewal period expiration dates. Enroll all billable providers in contracted Medicaid, Medicare, and Commercial Insurances and maintain provider credentialing and enrollment thereafter. Enroll all billable prescribers in 340B and maintain their database with SSCHC partner pharmacies. Function as the Administrator for all insurance websites/portals for registration and billing staff. Onboard providers with Greenway and maintain provider lists and invoices for payable Greenway services. Enroll prescribers in Electronic Prescription of Controlled Substances (EPCS) thru Greenway and provide support services for EPCS as needed.
Qualifications:
- High school diploma or GED
- Excellent oral and written communication skills with ability to pay close attention to details
- Working knowledge of computers and office applications software
- Ability to relate well to people from diverse ethnic and cultural backgrounds
Contact Information
No Phone Calls Please. Qualified applicants may apply online, send resume to Sue Raymond, Vice President of Human Resources, Sixteenth Street Community Health Centers, 1337 S. 16th St., Milwaukee, WI 53204 or fax to 414-672-0413. Sixteenth Street Community Health Centers is an equal employment opportunity employer.
Job Summary
Start Date
Immediately
Employment Term and Type
Regular, Full Time
Hours per Week
40
Work Hours (i.e. shift)
1st Shift
Required Education
High School or Equivalent
Required Experience
1+ years
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