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Medical College of Wisconsin · 12 hours ago

Credentialing Assistant

Milwaukee, WI

Full-time

Onsite

Entry Level

2+ years exp

The Medical College of Wisconsin is seeking a Credentialing Assistant who will perform various duties related to background verification and file preparation for credentialing functions. The role involves preparing re-credentialing files, verifying information from primary sources, and enrolling new providers into Medicare and Medicaid programs.

EducationHigher EducationMedical

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