Credentialing Assistant

Credentialing Assistant

Position Description : In the role of Credentialing Assistant, you will be working in Clinical Practice Services. You will perform a variety of duties that contribute to background verification and file preparation for the MCW credentialing function, and enrollment and maintenance of enrollment status of individual providers and clinical practice sites for public payer programs. The tasks that Credentialing Assistants perform require a consistently high degree of accuracy over a large volume of providers, and their work, though closely supervised, is relied upon and used directly in decisions regarding credentialing and enrollment. Hybrid Position : 60% Onsite & 40% Remote

Responsibilities :

• Prepares re-credentialing files for review and decision by MCW Credentialing Committees.
• Verifies specified information from identified primary sources, reviews re-credentialing applications for completeness, and pursues missing forms or information as needed.
• Prepares Individual Status Reports using information obtained from primary source verifications including assembling all re-credentialing information regarding each provider into re-credentialing files for review by MCW Credentialing Committees.
• Enrolls all newly hired MCW providers into Medicare and appropriate Medicaid programs by receiving applications for participation in Medicare and Medicaid programs from new providers. Checks for completeness and pursues additional information or materials as necessary. Works with personnel from government payers to secure application materials as necessary. Transmits completed applications to government payer; receives and files verification of enrollment.
• Prepares Candidate Background Assessment Program (CBAP) files for review and use in hiring decisions for clinical departments. Receives CBAP applications from candidates for faculty physician, dentist, and psychologist positions and verifies specific information from primary sources.
• Reports results of CBAP background searches to Office of General Counsel and clinical departments. Maintain records noting progress of each candidate in the CBAP process in spreadsheet software. Maintains individual files for all candidates using the CBAP process. Performs Quality Assurance Audits on all completed files for accuracy prior to releasing the files to the various entities.

Knowledge - Skills - Abilities :

The Medical College of Wisconsin is an affirmative action / equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, veteran status, disability or sexual orientation.