Medical Staff Coordinator

Job Details

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Job ID:
22824

Location:
450 Brookline Ave, Boston, MA 02215

Category:
Quality/Risk Management/Patient Safety

Employment Type:
Full time

Overview

Responsible for coordination and preparation of medical staff functions; prepares for committee meetings, takes minutes, processes and distributes appropriate correspondence. Works under the supervision of the Office of Medical Affairs and Professional Credentialing manager. The coordinator assists with the development, planning and implementation of the credentialing/privileging process. Assists in compliance with the accrediting and regulatory agencies (i.e. TJC, CMS, NCQA, etc.) in regard to credentialing while developing and maintaining a working knowledge of the statutes and laws. Ensures that all expirables are reviewed, obtained, and managed on a monthly basis according to rules and policies. Maintains the confidentiality of all business/work and medical staff information. Assists in managing the flow of information between the OMAPC team, Credentials, MSEC, Board committee members, Medical Staff Leadership (including the Department Chairs and Program Administrators). Assists in identifying, establishing, and fulfilling goals and objectives consistent with overall strategic goals. Other related administrative duties as assigned.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute brings together world renowned clinicians, innovative researchers and dedicated professionals, allies in the common mission of conquering cancer, HIV/AIDS and related diseases. Combining extremely talented people with the best technologies in a genuinely positive environment, we provide compassionate and comprehensive care to patients of all ages; we conduct research that advances treatment; we educate tomorrow's physician/researchers; we reach out to underserved members of our community; and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Requirements

PRIMARY DUTIES AND RESPONSIBILITIES:

 

  • Leads, 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.
  • Prepares credentials file for completion and presentation to department chair, Credentials Committee, and Medical Executive Committee.
  • Provides administrative management to various committees through document generation/agenda/minutes in preparation for meetings.
  • Coordinates out-of-state Medicaid enrollment process for the PO Foundations.
  • Builds and maintains CAQH files for providers.
  • Submits enrollment paperwork for all major health plans in the State.
  • Enrolls staff for ordering and referring status with Mass Health and Medicare.
  • Maintains enrollment database with their effective dates with the payers.
  • Works with delegated payers to maintain accurate enrollment rosters.
  • Processes provider terminations with all payers.
  • Manages deadlines as appropriate.
  • Performs miscellaneous job-related duties as assigned.

Qualifications

  • Bachelor’s degree required. In lieu of degree, will consider individual with 2-4 years directly related experience in provider enrollment and/or credentialing in a health care setting.
  • Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional Medical Services Management (CPMSM) certification(s) preferred.
  • Requires 3 years experience in medical staff services/provider enrollment credentialing.
  • Knowledge of managed care or provider credentialing required.
  • Knowledge of billing processes preferred.




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 groups as protected by law.

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