Weekend Member Operations and Experience Specialist – Advanced Research, Escalations
Public
Medical Staff Affairs Operations Manager
Boston Medical Center (BMC)
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Lead
About the role
- Responsible for the timely response to LIPs for applications and the coordination of submitted applications for either appointment or reappointment to the Medical-Dental Staff
- Assures that all credentialing procedures comply with the requirements of the Board of Registration in Medicine, the Joint Commission, the Bylaws of the Medical-Dental Staff and insurance companies
- Manages workflow of application submissions to assign files for processing by the Credentials Coordinators
- Maintains primary database for all LIP information at BMC community hospitals, overseeing the maintenance of records and participating in continuous improvement to examine processes and automation techniques to make operations more efficient
- Manages hospital privileging process for appointment/reappointment applications with Medical Executive Committee and Credentials Committee meetings, including but not limited to scheduling, preparing notices, reports, and other pertinent documents
- Prepares completed applications for approval process with Committee, including addressing clarifications and details based on anticipated inquiries during Committee process to ensure timely approval
- Facilitates the approval process through the credentialing software suite, and is responsible for follow-up with approvers and reviewers to ensure completion by proposed start dates/reappointment dates
- Leads and participates in reviews and audits by regulatory agencies or third-party payers, as appropriate
- Provides training and oversight to Credentials Coordinators, participating in performance review process with Director
- Provides backup and assistance to the Director of Medical Affairs & Credentialing, and Associate Director of Medical Affairs, as necessary
- Perform other duties to serve the operations and function of the medical staff office as assigned
Requirements
- Associates degree or equivalent experience required
- Requires 10 years of experience in a Medical Staff Office or credentials verification organization
- Bachelor’s degree preferred
- CPSC: Certified Provider Credentialing Specialist, preferred
- Extensive knowledge of credentialing procedures / requirements
- Ability to work professionally with all levels of personnel to establish and maintain collaborative working relationships with providers, chiefs of service, department directors, administrative staff, and outside agencies
- Strong communication, time management and organizational skills
- Ability to identify and solving problems in the credentialing and enrollment process as they arise
- Ability to prioritize duties, meet deadlines
- Ability to maintain sensitive and confidential information
- Knowledge of and ability to operate various computer software applications, including but not limited to Outlook, Word, Excel, and Power Point
- Able to function independently and perform routine department procedures without supervision
- Must complete a background check before beginning employment
- BMC requires all staff to be vaccinated against COVID-19 and flu, as well as receive a booster dose of the COVID-19 vaccine
- Participation in Electronic Employment Verification Program (E-Verify)
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
credentialing proceduresapplication processingworkflow managementauditingproblem solvingdata managementrecord maintenancecontinuous improvementenrollment processbackground check
Soft skills
communicationtime managementorganizational skillscollaborative working relationshipsindependenceattention to detailconfidentialitytrainingoversightperformance review
Certifications
CPSC: Certified Provider Credentialing Specialist
