Medical Staff Credentialing Director jobs in Wisconsin

Position Description:

Every day, in ways both big and small, the Medical College of Wisconsin (MCW) is impacting lives for the better. MCW ... changemaking for a healthier Wisconsin.

In the role of Credentialing Assistant, you will be working in Clinical Practice Services. You will 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.

Responsibilities:

• Prepares 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.
• Performs Quality Assurance Audits on all completed files for accuracy prior to releasing the files to the various entities.

Knowledge - Skills - Abilities

Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping.

Computer, technical, interpersonal, oral communication, listening, and patience skills.

Preferred Schedule:
Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.

Position Requirements:

Minimum Qualifications:

Appropriate experience may be substituted for education on an equivalent basis.

Minimum Required Education: High school diploma

Minimum Required Experience: 2 years

Preferred Qualifications: 2 years' experience enrolling and maintaining credentialing status for providers. Experience with MSOW or similar software, such as Cactus or MD-Staff.

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Why MCW?

• Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Pet Insurance
• On campus Fitness Facility, offering onsite classes.
• Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.

For a full list of positions see: www.mcw.edu/careers

For a brief overview of our benefits see: https://www.mcw.edu/departments/human-resources/benefits

Eastern Wisconsin is a vibrant, diverse metropolitan area. MCW is intent on attracting, developing, and retaining a diverse workforce and faculty body that reflects the community we serve. We value diversity of backgrounds, experience, thought, and perspectives to advance excellence in science and medicine. MCW is a welcoming campus community with a strong culture of collaboration, partnership, and engagement with our surrounding community. For more information, please visit our institutional website at https://www.mcw.edu/departments/office-of-diversity-and-inclusion.

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 a diverse 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.

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