Job SummaryResponsible for the supervision of staff members and management of processing times for initial and recredentialing. Responsible for team meetings and staff education. Acts on the behalf of the Credentialing Department as a resource/problem resolution for other departments. Collaborates with Manager of Credentialing for policies and procedures development. Coordinates system changes and represents the department in organizational process improvement initiatives.Essential Functions
Instructs and monitors Credentialing Coordinators for timely processing of credentialing and recredentialing. Provide work assignments for staff. Oversee completion of assigned duties. Provide help and direction to staff as needed.
Recruits, trains and evaluates staff. Develops and implements staff education programs to enhance staff performance. Initiates and promotes staff development to achieve departmental goals.
Manages all components related to the processing of Credentialing applications to ensure compliance with Insurance Carriers and Facilities (to include but not limited to: state licenses, drug enforcement applications, malpractice insurance, hospital applications.).
Works collaboratively with the Hospital Medical Staff Departments and office managers to facilitate the credentialing/recredentialing process for providers.
Prepare for and coordinate department meetings.
Maintains process to ensure confidentiality of files and sensitive information.
Assists Billing and Revenue Integrity with resolving claim rejections related to credentialing.
Qualifications
Required High School Diploma or equivalent
Preferred Associate's Degree or equivalent
2 years of relevant experience Skills, knowledge, abilities typically gained through 2+ years of related experience Required
2 years of relevant experience credentialing in a medical environment Required
2 years of relevant experience supervisory experience with strong leadership abilities Required
Knowledge of basic medical terminology. Required
Knowledge of Symed. Preferred
Physical Demands
Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
Waist to Waist > 5 lbs: Seldom up to 10 lbs
Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
Waist to Overhead > 5 lbs: Seldom up to 5 lbs
Bilateral Carry > 5 lbs: Seldom up to 10 lbs
Unilateral Carry > 5 lbs: Seldom up to 5 lbs
Pushing Force > 5 lbs: Seldom up to 25 lbs
Pulling Force > 5 lbs: Seldom up to 15 lbs
Sitting: Frequently
Standing: Occasionally
Walking: Occasionally
Forward Bend - Standing: Seldom
Forward Bend - Sitting: Seldom
Trunk Rotation - Standing: Seldom
Trunk Rotation - Sitting: Seldom
Squat: Seldom
Supine Lying: Seldom
Stair Climbing: Seldom
Crawling / Kneeling: Seldom
Driving: Seldom
Reach - Above Shoulder: Seldom
Reach - at Shoulder or Below: Seldom
Handling: Occasionally
Forceful Grip > 5 lbs: Seldom
Forceful Pinch > 2 lbs: Seldom
Finger/Hand Dexterity: Frequently
Visual Acuity ¹[None = No; Seldom = Yes]: Seldom
Primary LocationSITE - 4700 60th St - Grand RapidsDepartment NamePFS Provider Support And Enroll ServicesEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of Work8:00 a.m to 5:00 p.m.Days WorkedMonday to FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling 616.486.7447.People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.