Credentialing Assistant (Remote)

About the job

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Day - 10 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview

The Credentialing Assistant provides the necessary office and clerical services to the Management team of the department. Duties include maintaining filing and record keeping systems, performing administrative support, and other duties as assigned. This position assists the credentials coordinators and maintains the expirables for all medical staff and Advanced Practice Professional staff. May take meeting minutes as needed and monitor various email accounts. In addition, the Credentialing Assistant is responsible for assisting with enrollment processing and tracking of the enrollment while meeting regulatory requirements.

Locations

Stanford Health Care

What You Will Do

Assists credentialing staff as needed, i.e., intake and uploading of new credentialing documents, input of data into database, sending and receiving of application packets links, filing, etc.

Monitors, on an ongoing basis, all expirables, such as physician medical licenses, DEA certificates, Furnishing license, Fluoroscopy certificate, board certification and malpractice insurance, BLS, etc. to ensure that current documentation is present in credentials files, expiry dates are updated and in compliance with policies, comments are maintained in the database, Coordinators are kept informed, and appropriate follow-up and documentation is maintained. Other expirables may be included as per policy.

Supports ongoing monitoring activities for delegated credentialing and enrollment.

Answers departmental main phone line and refers calls to appropriate staff. Attempts to problem solve customer’s issue before forwarding on.

Processes medical staff verification requests from other health care entities and runs activity reports as needed.

Maintains departmental correspondence files.

Provides general clerical assistance as required by Director and assistant Director including special project requests, such as maintenance of the Hospital Staff, PA Students, and School of Medicine, MedHub Reports and Assistance, Stanford Risk Claims requests, WHW Clearance requests, and monitoring LPCH Ongoing Professional Practice Evaluation alerts.

Maintains confidentiality of documents and information.

Provides backup support for Medical Staff Assistant as needed.

Receive and distribute departmental mail.

Scan and upload images to credentialing database as appropriate.

Provide support to customers concerning paperless credentialing database.

Primary source for ordering and maintaining department office/computer supplies.

Maintains database tables in accordance with policy, such as Address Standardization and Updates – Office/Hospital/Insurance.

Ensures email and fax accounts are managed and up to date daily. This includes but is not limited to the following: MedStaff Account Monitoring (general questions), Provider Updates Account Monitoring, Find a Physician emails, MSSD Fax, Expirables, and personal email account. Reply to PreCheck emails.

Maintains the accounting for the department and ensures the information is kept up to date, follow up is handled appropriately, and staff notified of the status on an ongoing basis. Accounting may include but is not limited to balancing P-Card, maintaining balances on needed verification websites, application fees, late fees, dues and fees check deposits, credit card deposits, etc.

May establish a system of committee support for all assigned Medical Staff committees, ensuring appropriate clerical support, development of consistent formats, maintenance of committee materials, etc. Ensures that meeting minutes accurately reflect the discussion and action at meetings. Completes meeting minutes upon completion of meeting in a timely manner.

Has knowledge of Medicare, Medi-Cal, Medicaid, and CCS payor enrollment requirements.

Processes applications and other documents for completeness and complies with defined enrollment processes via the electronic system and any other method as defined within the department.

Verifies that requests for enrollment are appropriate based on set criteria.

Expected to analyze and problem solve while considering regulations, policies, procedures, and guidelines.

Closely monitors collection of all information. Reviews the quality of information received; tracks and acquires additional information in an organized fashion, when necessary, per established policies, procedures, guidelines, and regulations.

Initiates and/or completes or participates in enrollment expirables as outlined in policies, procedures, and guidelines. May initiate and/or complete for reverifications and deferral processes.

Proactively initiates and facilitates the Provider Enrollment process (new providers, provider changes, renewals, and locations), and identifies areas for improvements to the process.

Performs other related and incidental duties as needed or assigned.

Education Qualifications