Medical Credentialing Coordinator Family Medicine Residency of Western Montana

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Staff Vacancy Announcement

Family Medicine Residency of Western Montana (FMRWM)

invites applications for a

Medical Credential Coordinator

to join their team. This position works with the Credentialing Administrator at Partnership Health Center (PHC), the clinical training site for FMRWM, to ensure credentialing, re-credentialing, and insurance enrollments for FMRWM faculty and residents as well as Partnership Health Center providers. This person works closely with other FMRWM staff, faculty, PHC leadership, and other department

managers for credentialing purposes.

Key duties and responsibilities include:

Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant is eligible and qualified to provide care at the Family Medicine Clinic at PHC.

Maintains credentialing records.

Evaluates and maintains confidential data security.

Obtains and evaluates documentation regarding providers’ education, training, work history, licensure, regulatory compliance records, and malpractice history to credential new, and re-credential current, providers.

Maintains documentation in individual provider files.

Administers and maintains internal health professional roster to ensure all information is accurate and current.

Creates accounts and login credentials for providers.

Enrolls providers in the National Plan and Provider Enumeration System (NPPES) by entering provider information into national database.

Prepares and maintains initial credentialing and re-credentialing applications to add providers to commercial payers, Medicare, and Medicaid.

Completes provider insurance applications and submits to the appropriate insurance agency for enrollment.

Tracks insurance contract application status.

Prepares and maintains each provider’s Council for Affordable Quality Healthcare (CAQH) and Provider Enrollment, Chain, and Ownership System (PECOS) profiles.

Completes revalidation requests issued by government payers.

Responds to requests for information from outside entities.

Follows PHC’s established board-approved policy for malpractice claims management to ensure that PHC complies with Federal Tort Claims Act (FTCA) requirements and takes reasonable and appropriate action based on the circumstances of each claim.

Plans, organizes and facilitates Credentialing Committee meetings and records meeting minutes.

Provides administrative support for residency events, general office assistance, record keeping, and minute taking.

Following a reasonable training period, the incumbent will have working knowledge of:

Provider credentialing requirements.

PHC Standards of Care and Principles of Practice.

Medical terminology.

HIPAA requirements.

PHC Corporate Compliance Guidelines.

Basic knowledge of credentialing and its impact on PHC’s revenue cycle.

Residency academic year and related deadlines/requirements.

PHC/FMRWM partnership and skill in navigating the needs of both organizations.

Required Skills

Working knowledge of modern office practices and departmental work routines.

Ability to use personal computer and related software (Word, Excel, Outlook, internet).

Ability to use a keyboard (45 WPM recommended).

Ability to communicate in the English language, orally and in writing.

Ability to respect and maintain confidentiality and to be culturally sensitive to the medically underserved.

Ability to coordinate and respond to multiple demands, deadlines, and to remain calm/tactful in stressful situations.

Ability to establish and maintain effective working relationships with diverse individuals and groups at all levels of the organization in a dynamic environment.

Ability to work independently.

Ability to learn new software programs.

Ability to plan group events.

Ability to coordinate travel paperwork.

Dedication to lifelong learning and process improvement.

Minimum Required Experience

Associate degree in a heath care related field, as well as at least four (4) years experience in an office setting; OR any combination of experience and education that would provide the competencies required to successfully discharge the duties assigned to this position.

Preferred Qualifications

Bachelor’s degree in a healthcare related field. Degrees best suited to this position are Health Information Management and Medical Information Technology

CPCS (Certified Provider Credentialing Specialist) certification

Four (4) years of experience working in a medical office and credentialing experience

About FMR/AHEC

and UM

The Family Medicine Residency of Western Montana is a 3-year family medicine program sponsored by The University of Montana and affiliated with the University of Washington Family Medicine Residency Network. We exist to provide superior, comprehensive education in Family Medicine. We are committed to developing family physicians who are compassionate, clinically competent, and motivated to serve patients and communities in the rural and underserved areas of Montana.

PHC Mission: To promote optimal health and wellbeing for all through comprehensive, patient-focused, accessible and equitable care.

The University of Montana is flagship, research institution with approximately 10,000 undergraduate and graduate students. It is located in Missoula, a culturally vibrant community of about 75,000, surrounded by mountains and three rivers converge. Abundant recreational opportunities in surrounding state and national forests and nearby Glacier National Park and Yellowstone National Park complement a thriving intellectual atmosphere. The University of Montana offers eligible employees a generous benefits package that positively separates UM from other local employers and offers many programs and policies to support work-life balance for its employees.

The University of Montana is an Affirmative Action/Equal Opportunity employer and has a strong institutional commitment to the principle of diversity in all areas. In that spirit, we are particularly interested in receiving applications from a broad spectrum of qualified people who would assist the University in demonstrating its five priorities for action

: Place student success at the center of all we do; drive excellence and innovation in teaching, learning, and research; embody the principle of “mission first, people always; partner with place; and proudly tell the UM story.

To learn more about the University of Montana, please visit the links below.

University of Montana

Video: Mission First, People Always

UM on YouTube

Position Details

Position Title:

Licensed Certification Permit Tech

Position Number:

NEW

Department:

FMRWM

Work Schedule:

Full-time, 1.0 FTE (40 Hours a week), Monday through Friday 8:00 am to 5:00 pm, 12 months/year

Salary:

$20.35/hr

Current employee’s rate of pay for this position will be determined by the staff compensation plan and will minimally be this posted salary. For questions and details regarding the staff compensation plan

, email the

Compensation Department

Union Affiliation:

FOCUS-MFPE

Probationary Period:

Six months minimum

Benefits Include

Insurance package, mandatory retirement plan, partial tuition waiver, and wellness program.

Criminal Background Investigation is required prior to the Offer of Employment In accordance with University regulations, finalists for this position will be subject to criminal background investigations. ADA/EOE/AA/Veteran's Preference

Reasonable accommodations are provided in the hiring process for persons with disabilities. For example, this material is available in alternative format upon request. As an Equal Opportunity/Affirmative Action employer, we encourage applications from minorities, veterans, and women. Qualified candidates may request veterans’ or disabilities preference in accordance with state law. References:

References not listed on the application materials may be contacted; notice may be provided to the applicant. Testing:

Individual hiring departments at UM may elect to administer pre-employment tests, which are relevant to essential job functions. Employment Eligibility:

All New Employees must be eligible and show employment eligibility verification by the first date of employment at UM, as legally required (e.g., Form I-9).

Company info

The University of Montana
Website : https://www.umt.edu