Credentialing Coordinator at Partner's Healthcare in Somerville, Massachusetts

Job Description:

Site: Mass General Brigham Incorporated


At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission-from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.


At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare - people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds - to apply.



Job Summary
General Overview


The Credentialing Coordinator is primarily responsible for tracking and maintaining credentialing expirable documents. Responsible for the administrative duties required for the credentialing verification process. The Credentialing Coordinator also assists with activities associated with physician and advanced practice provider's credentialing and re-credentialing. Reviews, enters, and maintains credentialing information in the MGB Enterprise credentialing system. Ensures the credentialing process complies with organizational as well as accrediting agency, Federal and State regulatory standards.


Principal Duties and Responsibilities


- Track and maintain credentialing expiring documents including, but not exhaustive: medical licenses, professional licenses, MCSR, DEA, Insurance, ACLS, BLS, PALS, and NRP
- Compare primary source verified information with the information within the electronic record and enter data in the Enterprise credentialing system accurately
- Provide Credentialing Director with weekly updates on any missing or delinquent items as part of the expirable process
- Utilize credentialing websites to obtain primary source verifications
- Run reports to identify non-compliant items and run system verifications, if needed - Responsible for maintaining the integrity of provider data in the Enterprise credentialing system through ongoing monitoring and by ensuring data is entered and updated accurately
- Identify issues that require additional investigation and evaluations - Communicate with internal and external physicians, allied health professionals, other healthcare professionals, and managers regarding questions or issues in an effort to gather and maintain credentialing information
- Assist Credentialing Specialist with initial and reappointment application in accordance with the CCO policies and procedures
- Performs routine credentialing application audits for quality, completeness, and accuracy of data
- Assist with verifying credentialing elements, including but not limited to, education, training, board certification, work history, licensure and certifications, malpractice coverage
- Assist Credentialing Specialists with following-up on missing data to ensure that the credentialing application is completed within an established time frame - Analyze application material to assure that providers data is accurate in the electronic records
- Complete special projects as assigned
- General administrative tasks and other duties as assigned



Qualifications

• High school diploma or equivalent. Associate's or Bachelor's Degree in a related field preferred


• One year of experience in credentialing services or related field Skills, Abilities and Competencies


• Working knowledge of general office practices, software applications and database management


• Demonstrated understanding of credentialing policies


• Organizational skills required to handle high data flow and to prioritize tasks in order to meet deadlines


• Ability to manage demanding workload; self-motivated; able to carry out responsibilities with minimum supervision


• Analytical skills necessary to determine whether correct and complete information was provided on applications.


• Able to concentrate on tasks, paying meticulous attention to detail regardless of distractions


• Possesses ability to manage specialized database including producing credentialing reports


• Adheres to professional confidentiality standards in accordance with legal, ethical, and departmental policies


• Handles sensitive and confidential situations/information, with a high degree of tact and diplomacy


• Communicates effectively and professionally with applicants or colleagues by telephone or in person

Additional Job Details (if applicable)



Remote Type


Remote



Work Location


399 Revolution Drive



Scheduled Weekly Hours


40



Employee Type


Regular



Work Shift


Day (United States of America)



EEO Statement:


Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.




Mass General Brigham Competency Framework



At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Apply Now