Essential Job Responsibilities:

• Responsible for day-to-day management of credentialing process including workflows of direct reports.  
• Reviews provider applications and applicable documents, ensuring applicant eligibility.
• Serves as liaison between client sites and providers for credentialing processes and requirements as defined in client contracts and medical staff Bylaws.
• Identifies issues requiring additional documentation, validates discrepancies, and ensures appropriate follow up and communication.
• Ensures organizational compliance with all local, state and federal laws.
• Maintains oversite of facility credentialing and licenses for each provider of MAK Anesthesia to include monitoring renewals for expirable by provider. 
• Maintains QGenda workflows and other tracking documents for credentialing.
• Ensures that required supervising physician documents are completed during hiring and updated as needed. 
• Interfaces with internal and external customers on day-to-day credentialing and privilege requests/issues as they arise.
• Perform miscellaneous job-related duties as assigned.

Education and Certification: High school diploma or GED required; completed degree from an accredited institution in healthcare preferred.   Certified Provider Credentials Specialist (CPCS) or actively pursuing certification.  Job requires continuing education / development courses.    

Experience: Minimum of three years’ healthcare credentialing experience, preferably in a lead or manager role.

Performance Requirements:

Knowledge:

1. Knowledge of entire credentialing processes and ability to apply understanding in a timely fashion.
2. Knowledge of provider enrollment processes to include accurate payor submission and how it affects the billing/claim(s) lifecycle. 

Skills:

1. Demonstrating a high degree of initiative, judgment, and discretion to achieve organizational objectives.
2. Confidentiality with sensitive information.
3. Proficiency with Microsoft Office to include Excel, PowerPoint, and Word. 
4. Excellent verbal and written communication skills.
5. Establishing and maintaining effective working relationships with physicians, Allied Health Professionals, employees, policy-making bodies, and hospital employees required to navigate the needs of MAK Anesthesia.  

Abilities:

1. Analyze and prioritize tasks that require a heightened sense of urgency. 
2. Perform project planning as needed.
3. Recognize potential improvements to established policies and procedures. 

Work Environment / Physical Requirements: Normal office environment.  Requires sitting and standing.  Occasional evening work. 

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change.