Credentialing Specialist (Hybrid - Corporate Office) Detroit, MI Location Detroit, MI : Under general supervision, responsible for all functions relating to the credentialing and re-credentialing of practitioner applicants. Responsibilities include data entry, data collection, and verification of credentials from primary source and analyzes information collected for presentation to medical staff leadership. PRINCIPAL DUTIES AND RESPONSIBILITIES: Responsible for verifications for medical staff and allied health professionals initial appointments, provisional reviews, reappointments and privilege delineation. Coordinates the processing of applications. Assure all applications are processed completely and in a timely manner. Verifies required primary source credentialing documentation to ensure medical staff and allied health professional files are current and policies and procedures have been followed to obtain required documentation and verification. Coordinates activities and explains procedure to facilitate the reappointment process. Request confidential information such as case logs, procedures and other sensitive matters. Tracks responses and follows-up on items not received within established time frames. Maintains credentialing software database by ensuring that data entered is complete and accurate. Submit completed files to MSO offices and delegated entities. Acts as a liaison between Henry Ford Health System facilities and the CCS. Communicates with internal and external customers in a clear, concise manner to obtain or provide necessary information. Assist in compliance with the accrediting and regulatory agencies (i.e. The Joint Commission, NCQA, URAC, HFAP) in regards to credentialing while developing and maintaining a working knowledge of the statutes and laws. Improves professional growth, knowledge of job to maintain efficiency and effectiveness of the CCS by participating in professional organizations, attending seminars and reading journals and publications addressing medical staff services activities and trends. Participates in system integration and continuing quality improvement efforts. Receives, evaluates and answers customer inquiries and provides customer support in accordance with corporate standards of excellence. EDUCATION/EXPERIENCE REQUIRED: High School Diploma required. Associate's Degree, preferred. 1 year of credentialing, provider enrollment, or background/verification specialist experience required. High level of energy to work in a fast paced environment often including time deadlines, frequent interruptions, multiple demands and multi-tasking. Working knowledge of State and Federal law relating to due process and provisions of the Health Insurance Portability and Accountability Act if 1996 and all applicable standards. Experience with credentialing platform MD Staff a plus. Additional Details This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a
$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites
including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and
other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system
now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one
of the nation's oldest physician groups. An additional 2,200 physicians are also affiliated with the
health system through the Henry Ford Physician Network. Henry Ford is also one of the region's
major academic medical centers, receiving between $90-$100 million in annual research funding and
remaining Michigan's fourth largest NIH-funded institution. Also an active participant in medical
education and training, the health system has trained nearly 40% of physicians currently practicing
in the state and also provides education and training for other health professionals including nurses,
pharmacists, radiology and respiratory technicians. visit HenryFord.com.
Benefits Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Henry
Ford Health has a new approach for its employee benefits program - My Choice
Rewards. My Choice Rewards is a program as diverse as the people it serves. There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.
