Remote Free Medical Coding Training Jobs in Colorado

Ensures interpretation and compliance with the appropriate credentialing and regulatory agencies, while developing and maintaining a working knowledge of the statutes and laws relating to credentialing. Responsible for the accuracy and integrity of the credentialing database systems and related applications.  

ESSENTIAL FUNCTIONS AND BASIC DUTIES 

Supervisory-Specific Performance Expectations, Duties, and Responsibilities: 

• N/A 

Position-Specific Performance Expectations, Duties, and Responsibilities: 

• Leads, coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility. 

• Conducts thorough background investigation, research, and primary source verification of all components of the applicant’s file. 

• Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up. 

• Prepares credential files for completion and presentation to MRH and Medical Staff Committees, ensuring file completion within specified time periods. 

• Processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions. 

• Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise. 

• Assists with internal provider file audits. 

• Monitors the initial, reappointment, and expired credentials process for all medical staff, Allied Health Professional staff, other health professional staff, and non-employed/delegated providers, ensuring compliance with regulatory bodies as well as Medical Staff Bylaws, Rules and Regulations, policies and procedures, and contracts. 

• Prepares meeting agendas and takes minutes for Medical Staff Committees. 

• Utilizes credentialing software to maintain current records, licensures, and certifications. 

• Organizes and facilitates the Peer Review process as needed.  Maintains Peer Review documents in a locked file. 

• Prepares confidential reports for the Medical Executive Committee (MEC). 

• Establishes and maintains a professional relationship with all staff to resolve problems, working as a team. 

• Functions in a high-volume, multiple-task environment, while producing quality work. 

• Prioritizes workload and completes assignments within allotted time. 

• Able to work independently and problem-solve. 

• Must meet established productivity and quality guidelines. 

• Attends all applicable workshops. 

• Responsible for monitoring directed indicators. 

• Performs other duties as assigned. 

Organization-Specific Performance Expectations, Duties, and Responsibilities: 

• Demonstrates full commitment to the CHOICE values of MRH and consistently represents the organization in a positive, professional manner. 

• Establishes and maintains effective verbal and written communication, fostering positive working relationships with patients, staff, and vendors. 

• Adheres to the MRH attire and dress code in accordance with organizational policies and procedures. 

• Exhibits initiative and self-motivation; maintains a consistent level of productivity and manages time and responsibilities effectively. 

• Completes all required annual education, training, in-services, and licensure/certification updates; actively participates in departmental and organizational meetings or reviews meeting minutes as required. 

• Maintains strict patient confidentiality at all times. 

• Reports to work punctually and completes assigned duties within established timeframes. 

• Actively contributes to departmental and organization-wide performance improvement and continuous quality initiatives. 

• Ensures compliance with all regulatory requirements, maintaining adherence to departmental, hospital, state, and federal standards and policies. 

• Follows all infection control, safety, and risk management procedures to maintain a safe environment for patients, the public, and staff. 

QUALIFICATIONS 

• Must be at least 18 years of age (21 for positions requiring driving, with a valid driver’s license). 

• Must be legally authorized to work in the United States. 

• Must successfully pass a background check. 

• Must successfully pass a pre-employment drug screen and breath alcohol test (if applicable). 

• Must complete an Employee Health meeting prior to starting employment. 

EDUCATION, LICENSURE(S), AND CERTIFICATION(S) 

Required 

Preferred 

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Bachelor’s degree in Business Administration, Healthcare Administration, or related field. 

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National Association Medical Staff Services (NAMSS) as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS). 

EXPERIENCE 

Required 

Preferred 

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One (1) year of experience directly related to hospital medical staff or managed care credentialing.