75% Medical Staff Duties
1. Manages deadlines and priorities in gathering information and completing managed care plan applications.
2. Works with online systems for Medicare and Medicaid to credential and re credential providers.
3. Keeps all Medical Staff department informed as to progress of information gathering
.
Works with providers to resolvedeficiencies.
4. Resolves problems related to credentialing and re-credentialing for the managed care plans. Works with provider representatives directly in regard to additional information that may be needed to complete credentialing.
5. Compiles and maintains updated provider information and initiates calls to the various Departments and physicians to obtain specific current information, such as updated physician licenses, board certifications, narcotic licenses, physician health care plan applications, and C.V.'s
.
6. Responsible for initiating and maintaining a current file for each employed member of SIU Physicians
&
Surgeons Inc. which includes all NCQA required documentation for credentialing. Much of the information is found utilizing internet searchengines.
7. Maintains credentialing database, including uploading documents preparing applications and reports, and assisting departmentusers.
8. Responsible for managing their own alpha split of providers.
25%
Clerical Duties
1. Composes letters and memoranda containing confidential or sensitive information as requested
,
which very often require in depth knowledge of managed careprocedures.
2. Types from drafts, documents such as procedures
policies,
memoranda, managed health care provider credentialing applications, informational notices to managed health care plans, and special project reports. Corrects typographical
,
spelling, punctuation, and grammaticalerrors.
3. Coordinatesarrangementsformeetingsandtrainingsessionsbynotifying participants, acquiring conference rooms, and arranging any catering of food. Responsible for apprising the Director of Managed Care of all meetings. Obtains materials needed to assure a productive outcome.
4. Greets physicians and other visitors
,
answers telephones, screens calls, and handles as many calls as possible and takes accurate telephone messages for the staff in the Medical Staff Office. Projects a professional, efficient image and maintains a courteous and friendly attitude
.
5. Responsible for maintaining, preparing and distributing quarterly agendas of the Managed Care Networking Group(MCNG).
Responsible for insuring meeting room has the equipment necessary for any presentations made to the group
,
including telephone
conferencing and webinars. Accompanies the Medical Staff Specialist II to all MCNG meetings and other meetings as requested.
6. Independently prepares spreadsheets and inputs data into various spreadsheets utilizing the Excel and Microsoft Word programs on the computer. Prepares reports from those databases including New Provider Credentialing Status report, for distribution to department management.
7. Supervises the maintenance of comprehensive files and records system for a large area
,
which includes confidential information and maintains a current listing of all files utilized by the Medical Staff Office.
8. Responsible for requesting health care plan specific Certificates of Insurance for Professional Liability Insurance for members of SIU Physicians & Surgeons
,
Inc.
9. Sensitive to the needs of underrepresented minority populations
SIU Medicine
$3,394.63 - $3,733.93 Monthly
medical insurance, dental insurance, life insurance, paid time off, paid holidays, sick time, extended sick time, tuition reimbursement, 403(b), retirement plan
May 16, 2025