Dana-Farber Cancer Institute
Job Description
Responsible for coordination and preparation of medical staff credentialing functions. Assists with all functions related to the credentialing and provider enrollment of practitioners as outlined in the medical staff bylaws, policies, or related contracts or as required by accrediting and regulatory agencies (i.e., TJC, CMS, NCQA). Ensures compliance with appropriate accrediting and regulatory agencies. The coordinator assists with the development, planning and implementation of the credentialing/privileging and provider enrollment process. Ensures that all expirables are reviewed, obtained, and managed on a monthly basis. Maintains the confidentiality of all business/work and medical staff information. Responsible for the accuracy and integrity of their credentialing and enrollment files. Prepares for Credentials Committee meetings, correspondence. Assists in managing the flow of information between the OMAPC team, Revenue Cycle, Finance Teams and Credentials Committee, Department Chairs and Program Administrators.
Responsibilities
Coordinates and monitors the review and analysis of practitioner applications and accompanying documents for all credentialing and provider enrollment of physicians and allied health applicants.
Conducts thorough background investigation, research and primary source verification of all components of the application file.
Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow up with Manager/Supervisor.
Prepares credentials file through completion and presentation to department chair and Credentials Committee.
Builds/maintains CAQH files for providers and coordinates out-of-state Medicaid enrollment process for the PO Foundations as well as health plans. Submits enrollment paperwork for all major health plans.
Enrolls staff for ordering and referring status with Mass Health and Medicare and maintains database with payer effective dates.
Other duties as assigned.
Qualifications
High school diploma or equivalent experience.
1 year experience in medical staff services/provider enrollment credentialing preferred.
Ability to organize/prioritize workload.
Working knowledge of MD-Staff software preferred.
Working knowledge of Microsoft Office software.
Excellent written and verbal communication skills.
Strong customer service skills and the ability to interact with diverse groups.
Pay Transparency Statement The hiring range is based on market pay structures, with individual salaries determined by factors such as business needs, market conditions, internal equity, and based on the candidate’s relevant experience, skills and qualifications. For union positions, the pay range is determined by the Collective Bargaining Agreement (CBA). $28.37/hr – $31.30/hr
Dana‑Farber Cancer Institute is an equal‑opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.
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Responsibilities
Coordinates and monitors the review and analysis of practitioner applications and accompanying documents for all credentialing and provider enrollment of physicians and allied health applicants.
Conducts thorough background investigation, research and primary source verification of all components of the application file.
Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow up with Manager/Supervisor.
Prepares credentials file through completion and presentation to department chair and Credentials Committee.
Builds/maintains CAQH files for providers and coordinates out-of-state Medicaid enrollment process for the PO Foundations as well as health plans. Submits enrollment paperwork for all major health plans.
Enrolls staff for ordering and referring status with Mass Health and Medicare and maintains database with payer effective dates.
Other duties as assigned.
Qualifications
High school diploma or equivalent experience.
1 year experience in medical staff services/provider enrollment credentialing preferred.
Ability to organize/prioritize workload.
Working knowledge of MD-Staff software preferred.
Working knowledge of Microsoft Office software.
Excellent written and verbal communication skills.
Strong customer service skills and the ability to interact with diverse groups.
Pay Transparency Statement The hiring range is based on market pay structures, with individual salaries determined by factors such as business needs, market conditions, internal equity, and based on the candidate’s relevant experience, skills and qualifications. For union positions, the pay range is determined by the Collective Bargaining Agreement (CBA). $28.37/hr – $31.30/hr
Dana‑Farber Cancer Institute is an equal‑opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.
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