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Credentialing Specialist

Requisition #

65241BR

Physical Location

Minneapolis, Minnesota

Posted Date

17-Jul-2020

Schedule Type

Full-Time

Dept. Name

Credentials Verification Offce

Hours Per Week

40

Contract

Noncontract

Introduction

Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 12 hospitals, 16 pharmacies, specialty care centers and specialty medical services that provide home care, senior transitions, hospice care, home oxygen and medical equipment, and emergency medical transportation services. Allina Health is a vibrant, growing organization with opportunities to suit your professional skills and a diverse work environment to match your specific interests. We believe employees are our greatest asset and are dedicated to helping you develop and maximize your professional skills.

The Commons, located in Minneapolis, is the headquarters of Allina Health, a not-for-profit health care organization serving patients and communities. Approximately 1,600 corporate and administrative service employees work at offices within Midtown Exchange, the site of the historic Sears retail complex at Chicago Avenue and E. Lake Street. This community landmark, adjacent to the campus of Abbott Northwestern Hospital, part of Allina Health, is the second largest building in Minnesota and includes offices, an internationally themed public market and residential units.

 

Responsibilities

Req ID: 65241
Process credentials files for hospital and delegated payer credentialing that contain dated, accurate, approved content. Communicate status of application directly to providers and administrators. Monitor all aspects of the application process and evaluate for a total picture of the applicant’s background. Ensure credentialing files meet all regulatory requirements. Import and process electronic data and files. Review applications and other data for accuracy and completeness. Primary source verify required elements of the application. Contact applicant or coordinator to resolve questions and/or to obtain missing information or documentation. Escalate issues to manager as soon as possible. Collect, analyze, and maintain provider data. Import and enter data accurately and according to standards. Maintain accuracy and timeline standards Review all documents for accuracy and legibility. Process files to meet and maintain regulatory and accrediting standards and bylaws (TJC, NCQA, CMS, DHS etc.). Understand and adhere to Allina’s principles and standards. Protect data privacy at all times
  • Maintain electronic credentials files that meet all regulatory agency requirements
  • Serve as the person responsible for processing credentials files that contain dated, accurate, approved content on time, verify professional history, communicate the status directly to providers and administrators and meet regulations.
  • Monitor all aspects of the file process and evaluate for a total picture of the provider’s background.
  • Process initial and re-credential files for the Medical Staff and Allied Staff within Allina

Education

  • Bachelors degree preferred or
  • Equivalent degree plus experience

Qualification/Skills

Qualifications/Skills :
  • Experience with credentialing hospital medical staff files
  • Experience with credentialing clinic medical staff files
  • Experience processing primary source verifications
  • Knowledge of credentialing regulations
  • Ability to work in a fully electronic paperless office
  • Knowledge of credentialing, verifications and regulatory environment
  • CPCS preferred
  • MSOW experience a plus

Work Schedule

  • Monday - Friday
  • 40 hours per week
  • Non-contract
  • Benefit Eligible

Location/Community Information

Minneapolis boasts being both cosmopolitan yet small enough that you can find a place to call home whether on a lake, golf course, or in an adjoining suburb. With the fast pace of activity there are professional sports, theater, or enough parks for a quiet walk. The area has numerous schools and colleges, both public or private, and enough teams for all weekend athletes to join.

  • Located in Minneapolis
  • Population = 380,000
  • Service Area = 2,882,245

Community Resource Links:

Community Information School Digger

Explore Minnesota MN Dept of Education

Minneapolis St. Paul MagazineSt. Paul Pioneer Press

Twin Cities Living MagazineStar Tribune


Closing

If you are interested in becoming part of our award winning team of professionals, please apply online today. Allina Health is committed to providing Equal Employment Opportunities to all employees and applicants. EO M/F/Disability/Vet Employer.


Requisition #

65241BR
Administrative