Ensures the timely completion of an application for initial and/or re-credentialing by assisting the applicant in submitting all documentation necessary to process the application. Performs a variety of credentialing tasks to complete the credentialing process for Government Medical Services. This position is an integral part of the credentialing team and is responsible for following credentialing policies and procedures, maintaining an accurate physician database, collecting data, and participating in the development and implementation of changes to the credentialing processes and Facilitate Credentialing/Privileging Committee meetings. Performs file audits and provides feedback on completed initial and reappointment credentialing files.Assists in daily data entry to ensure an accurate healthcare provider database.Communicates regularly with applicants to complete all requirements of the credentialing criteria within specified timeframes.Contact various primary sources to gather the required verifications to complete the background investigation via telephone, fax transmissions, mailings, and Internet to ensure rapid completion of the application.Prepares documentation of all verifications including a summary of all verified references for each completed credentials file.Assists in the reappointment process; collecting required information, verifying information, and completing appropriate follow-up to complete the reappointment application.Meets processing time thresholds consistently and with minimal error.Maintains a customer-focused attitude, good rapport, and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution. Tracks errors and complaints to assist with process improvement activities.Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner.Helps to identify problems, offer solutions, and participate in their resolution.Maintains the confidentiality of information acquired pertaining to patients, and physicians. Discusses patient and hospital information only among appropriate personnel in appropriately private places.Assumes responsibility for the performance of job duties in the safest possible manner, to ensure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.Performs other duties as needed and assigned by the HQ Operations Manager.Maintains a working knowledge of applicable Federal, State, and local laws/regulations; the Government Medical Services and Compliance Program and Code of Conduct; as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
