Credentialing Assistant (Remote)

at  Stanford Health Care

1.0 FTE Full time Day - 10 Hour R2442052 Remote USA 108710002 Med Staff Services Technology & Digital Solutions
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Day - 10 Hour (United States of America)

EDUCATION QUALIFICATIONS

• High school diploma, or GED. College degree preferred.

EXPERIENCE QUALIFICATIONS

• Four (4) or more years of clerical, secretarial or office support work
• Two (2) years of experience in healthcare setting (Physician practice, outpatient or clinic setting), health maintenance organization (HMO), or insurance company may meet the requirement depending on work performed)
• One (1) year of credentialing related and/or provider enrollment and/or billing experience preferred

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES

• Ability to type minimum 65 wpm.
• Knowledge of computer applications and word processing required. (Knowledge of Microsoft Word and Excel preferred.)
• Excellent organizational, inter-personal, and communication skills (both oral and written) are essential, including the ability to prepare accurate, and timely reports, meeting minutes, policies, etc.
• Ability to interact with all levels of management and able to set priorities and manage multiple demands effectively.
• Ability to function independently with excellent judgment and minimal supervision as well as the ability to function in a team capacity.
• Ability to demonstrate discretion, confidentiality, tact, and the ability to deal with sensitive.

SHC COMMITMENT TO PROVIDING AN EXCEPTIONAL PATIENT & FAMILY EXPERIENCE

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Base Pay Scale: Generally starting at $35.84 - $40.38 per hour
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage

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 establishes 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.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordinatio