Credentialing Assistant - Clinical Practice Services

The Medical College of Wisconsin, Inc.; Wauwatosa (WI); Hybrid; USD 25,000 - 34,000; Full time

Benefits offered by this job

Healthcare Coverage

403b Retirement Plan

Paid vacation and holidays

Tuition reimbursement

Parental leave

Pet insurance

Fitness facility on campus

Job summary

The Medical College of Wisconsin, Inc. is seeking a Credentialing Assistant to support background verification and file preparation for credentialing and enrollment for public payer programs.

The role requires attention to detail, accuracy, and the ability to manage high volumes of provider records. This hybrid position (60% onsite, 40% remote) is restricted to candidates living in the Metro Milwaukee, WI area.

Qualifications

• Requires high school diploma.
• Minimum 2 years of related experience.
• Proficiency with spreadsheet software.

Responsibilities

• Prepares re-credentialing files for review by MCW Credentialing Committees.
• Verifies information from primary sources and pursues missing forms as needed.
• Enrolls new MCW providers into Medicare and Medicaid programs; coordinates with government payers.
• Maintains CBAP files and tracks candidate progress.

Job description

SummaryCredentialing Assistants perform a variety of duties that contribute to background verification and file preparation for the MCW credentialing function, and enrollment and maintenance of enrollment status of individual providers and clinical practice sites for public payer programs. The tasks that Credentialing Assistants perform require a consistently high degree of accuracy over a large volume of providers, and their work, though closely supervised, is relied upon and used directly in decisions regarding credentialing and enrollment.Hybrid position: 60% Onsite, 40% Remote, must live in Metro Milwaukee, WI area.Primary ResponsibilitiesPrepares re-credentialing files for review and decision by MCW Credentialing Committees.Verifies specified information from identified primary sources, reviews re-credentialing applications for completeness, and pursues missing forms or information as needed.Prepares Individual Status Reports using information obtained from primary source verifications including assembling all re-credentialing information regarding each provider into re-credentialing files for review by MCW Credentialing Committees.Enrolls all newly hired MCW providers into Medicare and appropriate Medicaid programs by receiving applications for participation in Medicare and Medicaid programs from new providers. Checks for completeness and pursues additional information or materials as necessary.Works with personnel from government payers to secure application materials as necessary. Transmits completed applications to government payer; receives and files verification of enrollment.Prepares Candidate Background Assessment Program (CBAP) files for review and use in hiring decisions for clinical departments.Receives CBAP applications from candidates for faculty physician, dentist, and psychologist positions and verifies specific information from primary sources.Reports results of CBAP background searches to Office of General Counsel and clinical departments.Maintain records noting progress of each candidate in the CBAP process in spreadsheet software.Maintains individual files for all candidates using the CBAP process.Knowledge – Skills – AbilitiesKnowledge of quality control, customer service standards, information management, procedural process, and recordkeeping.Computer, technical, interpersonal, oral communication, listening, and patience skills.QualificationsMinimum Required Education: High school diplomaMinimum Required Experience: 2 years#LI-RT1Physical RequirementsWork requires occasionally lifting moderate weight materials, standing, or walking continuously.Work EnvironmentOccasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.Sensory AcuityAbility to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.Why MCW?Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options403B Retirement PackageCompetitive Vacation and Paid Holidays offeredTuition ReimbursementPaid Parental LeaveEmployee & Family Assistance Program (EFAP)Pet InsuranceOn campus Fitness Facility, offering onsite classesAdditional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.For a brief overview of our benefits see: Benefits OverviewFor a full list of positions see: MCW CareersAt MCW all of our endeavors, from our internal operations to our interactions with our partners, are driven by our shared organizational values: Caring – Collaborative – Curiosity – Inclusive – Integrity – Respect. We are committed to fostering an inclusive environment that values diversity in backgrounds, experiences, and perspectives through merit-based processes and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world, and we recognize that a healthy and thriving community starts from within. Our values define who we are, what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all, then MCW is the place for you. For more information, please visit our institutional website.MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination:The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.