Credentialing Coordinator - Mass General Brigham : Job Details
Credentialing Coordinator
Mass General BrighamJob Location : Brighton,MA, USA
As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care, and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research. We're focused on a people-first culture for our system's patients and our professional family. That's why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees' personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development-and we recognize success at every step. Our employees use the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration. General Overview The Credentialing Coordinator is primarily responsible for tracking and maintaining credentialing expirable documents. Responsible for the administrative duties required for the credentialing verification process. The Credentialing Cooridinator also assists with activities associated with physician and advanced practice provider's credentialing and recredentialing. Reviews, enters, and maintains credentialing information in the MGB Enterprise credentialing system. Ensures the credentialing process complies with organizational as well as accrediting agency, Federal and State regulatory standards. Principal Duties and Responsibilities
- Track and maintain credentialing expiring documents including, but not exhaustive: medical licenses, professional licenses, MCSR, DEA, Insurance, ACLS, BLS, PALS, and NRP
- Compare primary source verified information with the information within the electronic record and enter data in the Enterprise credentialing system accurately
- Provide Credentialing Director with weekly updates on any missing or delinquent items as part of the expirable process
- Utilize credentialing websites to obtain primary source verifications
- Run reports to identify non-compliant items and run system verifications, if needed
- Responsible for maintaining the integrity of provider data in the Enterprise credentialing system through ongoing monitoring and by ensuring data is entered and updated accurately
- Identify issues that require additional investigation and evaluations
- Communicate with internal and external physicians, allied health professionals, other healthcare professionals, and managers regarding questions or issues in an effort to gather and maintain credentialing information
- Assist Credentialing Specialist with initial and reappointment application in accordance with the CCO policies and procedures
- Performs routine credentialing application audits for quality, completeness, and accuracy of data
- Assist with verifying credentialing elements, including but not limited to, education, training, board certification, work history, licensure and certifications, malpractice coverage
- Assist Credentialing Specialists with following-up on missing data to ensure that the credentialing application is completed within an established time frame
- Analyze application material to assure that providers data is accurate in the electronic records
- Complete special projects as assigned
- General administrative tasks and other duties as assigned
- High school diploma or equivalent. Associate's or Bachelor's Degree in a related field preferred
- One year of experience in credentialing services or related field
- Working knowledge of general office practices, software applications and database management
- Demonstrated understanding of credentialing policies
- Organizational skills required to handle high data flow and to prioritize tasks in order to meet deadlines
- Ability to manage demanding workload; self-motivated; able to carry out responsibilities with minimum supervision
- Analytical skills necessary to determine whether correct and complete information was provided on applications.
- Able to concentrate on tasks, paying meticulous attention to detail regardless of distractions
- Possesses ability to manage specialized database including producing credentialing reports
- Adheres to professional confidentiality standards in accordance with legal, ethical, and departmental policies
- Handles sensitive and confidential situations/information, with a high degree of tact and diplomacy
- Communicates effectively and professionally with applicants or colleagues by telephone or in person