Job Description

Job Description

Job Description

General Information:

Job title: Credentialing Specialist

Schedule: Full-time, 80 hours per pay period; Monday-Friday, scheduled between 8:00am - 5:00pm

Weekend Requirement: None

Holiday Requirement: None

Position Summary:

The Credentialing Specialist completes facility and provider privileging, credentialing, economic credentialing/payer enrollment, payer directory updates, and verifications, and maintains provider databases as required by state law, accrediting bodies, and payers.

Position Responsibilities:

• Provide administrative and credentialing support for the activities of the Medical Staff of Mile Bluff Medical Center. Assist with all medical staff requirements and maintain records and systems that result in efficient program operations. Support the medical/dental/allied health credentialing process, including processing of new applications, requests for additional and/or temporary privileges, and biennial reappointments.
• Verify competence, Medical and/or Professional Education, residency, internships, fellowships, additional formal training, relevant board certifications, health care affiliations, work history, military experiences, professional references, licensure and certifications, DEA certifications, malpractice coverage, and requested privileges. Query NPDB as appropriate and manage expirables.
• Maintain credentialing databases, assuring accuracy and completeness. Organize and maintain credential files in the medical staff office. Present completed files to the Credentials Committee for recommendation and approval of appointments and privileges.
• Maintain and update payer directories and rosters per CMS regulations. Maintain working knowledge of Medical Staff Bylaws and applicable hospital policies to ensure medical staff compliance. Comply with current Joint Commission standards and state and federal laws pertaining to the medical staff, and applying them to the credentialing process as needed.
• Perform other duties as requested.

Position Requirements:

• High school diploma or equivalent required. Two-year degree preferred.
• 1+ years of related work experience required.
• Exceptional accuracy and attention to detail required.

Knowledge, Skills, & Abilities

• Intermediate proficiency with computers is required, including Office applications.
• Ability to maintain strict confidentiality.
• Knowledge of medical terminology, state licensing requirements, and accreditation standards.
• Must possess exceptional organizational and communication skills.
• Self-starter with excellent interpersonal communication and problem-solving skills.

Why Mile Bluff Medical Center?

Mile Bluff Medical Center is a place where people come first. Our team is comprised of caring, patient-centered professionals serving pediatric through geriatric populations in our rural community. Our not-for-profit organization prides itself on providing state-of-the-art healthcare services, a positive work environment, and a team where employees feel valued and supported. Mile Bluff is an independent organization that offers competitive wages, great benefits and the opportunity for growth. Mile Bluff makes decisions for its employees and patients locally without relying on a large health system in another community.

Mauston Location Description

With a population of 4,500, Mauston maintains a small town feel while being surrounded by unique recreational and cultural experiences. Located on the Lemonweir River and next door to Wisconsin's second and fourth largest lakes, Petenwell and Castle Rock Lake, our community finds you surrounded by natural wonder, wildlife and a rich variety of outdoor recreation. Mauston is centrally located in southwestern Wisconsin on Interstate 90-94, approximately 73 miles to Madison, 140 miles to Milwaukee, and 215 miles to each Chicago and Minneapolis.

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