Position supports and facilitates all aspects of the system credentials verification process for medical staff government and managed care provider appointments and re-appointments.
PRIMARY DUTIES AND RESPONSIBILITIES:
Accountable for initial and continuous verification of credentials of medical staff members, health care providers for medical staff government and managed care providers. Accountable for ensuring ongoing state and federal licensure, compliance with JCAHO and NCQA standards and observance of applicable hospital medical staff by laws and managed care provider contracts and agreements.
Ensures maintenance of current and accurate data/information in system departmental credentials database. Appropriately utilizes the database to produce reports, lists, rosters, etc., internally and assisting the department's secretaries, WUPN and BJC facilities, as needed.
Maintains the permanent credentials files on all applicable medical staff members, government and managed care providers. Assures accuracy of records and maintains a state of readiness at all time for review/audit by delegated entities, licensing and accrediting agencies.
Assures the confidentiality and integrity of all aspects of the credentialing verification program and process.
Responsible for resolving claim rejection and denials related to provider records and credentialing.
Communicates credentialing statuses through all phases of the credentialing and re-validation process with department leaders.
Equivalent of high school diploma with 3 – 5 years’ experience is required.
Prefer past medical staff office or credentialing verification experience.
This position is in the Department of Radiology.� The position is located at 4533 Clayton Avenue.� This position is for the Medical School Campus.
Internal Applicant Instruction:
This position is grade C08.
Please attach a copy of your most current signed performance evaluation (completed within the last 18 months) to your online account.� If you have not received a performance evaluation, you may provide two current signed letters of recommendation (written within the last 18 months), preferably to include one letter from either a current or recent former supervisor.�� To attach these documents, go to:� My Career Tools, Add Attachment, Attachment Type � Performance Reviews or Letters of Recommendation.
This position is full-time and works approximately 40 hours per week.
The minimum to midpoint of the salary range is $18.81 - $23.52 per hour.
Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.
Washington University in St. Louis, a medium-sized, independent university, is dedicated to challenging its faculty and students alike to seek new knowledge and greater understanding of an ever-changing, multicultural world. The University offers more than 90 programs and almost 1,500 courses leading to bachelor's, master's and doctoral degrees in a broad spectrum of traditional and interdisciplinary fields, with additional opportunities for minor concentrations and individualized programs. The faculty is composed of scholars, scientists, artists and members of the learned professions. They serve society by teaching; by adding to the store of human art, creativity, understanding, and wisdom; and by providing direct services, such as health care.