Experience a rewarding and fulfilling career with Mercyhealth. Mercyhealth is committed to offering our partners a best place to work. Our unique workplace Culture of Excellence is built upon:
Employee engagement, empowerment and growth
Teamwork toward our common goal – providing exceptional health care services with a passion for making lives better
An atmosphere of caring and quality that cascades throughout the organization
Essential Duties and Responsibilities
Maintains high quality, timely and accurate credentialing processes of medical and allied healthcare professionals based upon system policies and procedures.
Assists in the credentialing process by entering, logging, scanning information into the system for initial appointments, reappointments, add-on applications and maintenance.
Completes and ensures compliance and delivery of required information to all customers in a timely manner.
Processes and maintains credentialing and re-credentialing in accordance with Mercy policies and procedures, Joint Commission standards, State and Federal regulatory guidelines.
Ensures that all credentials are current and complete pursuant to expiration date of medical licensure, board certification, professional liability insurance coverage, DEA and other pertinent information per Mercy policy/procedure.
Monitors collection of all information received. Follow-up on missing items/documentation/incomplete forms. Submits follow-up requests, as needed.
Identifies and evaluates potential red flags and works in collaboration with practitioner(s) to document the issue and practitioner response.
Advises supervisor and/or director of questionable information received and any issues identified during processes.
Submits closed files for audit/final review and secures missing items as identified by audit/final review.
Maintains all credentials files to ensure that all correspondence is accurately filed; is knowledgeable and current in regard to process and legal/regulatory requirements.
Maintains compliance with Mercy policies/procedures, federal, state and all accrediting agencies as required.
Responds to verification requests from hospitals and managed care organizations. Orders Medical Staff Office supplies. Bills for Medical Staff dues. Works with agencies and practitioners to assemble credentials files and arranges for review and secures signatures for locum tenens privileges. Serves as a resource for the Medical Staff on Medical Staff Bylaws issues. Assists physicians in developing criteria for privileging. Schedules and secures rooms for Medical Staff meetings, sends out notices, drafts agenda, assembles meeting materials, drafts minutes and follow-up correspondence. Maintains information in CACTUS database. Produces labels and writes reports from database. Maintains meeting attendance records in CACTUS database. Maintains Mercy sponsored CME records in CACTUS database.
Education & Experience
Associate's degree and 1 year of healthcare credentialing experience preferred(healthcare facility, managed care setting, CVO, or medical staff office), or a minimum of 5 years of experience in credentialing (preferred) or healthcare business area required.
CPMSM or CPCS preferred or commitment to pursue certification within two years.
Special Physical Demands
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. In order to perform the demands of this job, the employee may sit for long periods, exerting up to 10 pounds of force occasionally, walking and standing occasionally. The employee is required to frequently reach with hands and arms, finger, handle, talk and hear. Manual dexterity is required. Specific vision abilities required by this job include close vision and ability to adjust focus, particularly as it relates to computer screens.
EOE&AA/M/F/Vet/Disabled. Mercy is an equal employment opportunity employer functioning under Affirmative Action Plans.
Mercyhealth is a non-profit regional health care organization with more than 8,000 employee partners, 5 major hospitals, and 80 facilities and clinics throughout the Northern Illinois and Southern Wisconsin region. We are committed to being a top integrated health care provider and continuously work to make life better for the people, families and communities we serve.
Our partners serve with compassion, dedication, pride and professionalism. Our culture focuses on employee engagement, empowerment and growth, working together as a team to achieve one common goal: our mission of providing exceptional health care services, resulting in healing in the broadest sense and a best-in-class place to work for our partners.
We place great importance on providing our partners the tools, resources, facilities, and support to create lifelong career opportunities with an emphasis on a rewarding work-life balance. We achieve this by offering partners:
• Competitive compensation and benefits
• Tuition and certification reimbursement
• Generous PTO accruals
• Career ladder and advancement opportunities
• Partner recognition days and achievement awards
• Local/regional discounts and incen...tives
At Mercyhealth, we serve with a passion for making lives better, and we truly believe our accomplished staff is second to none in this mission. We hope you’ll consider becoming part of the Mercyhealth family.