Scheduled Hours

40

Position Summary

Full-time position completing and following up on insurance credentialing for all payers. Position may require office work 1-4 days a month typically, otherwise remote.

Supports and facilitates all aspects of the system credentials verification process for medical staff and managed care provider appointments and re-appointments. Includes credentials verification of allied health providers as required.

Job Description

• Responsible for the enrollment of new providers with Medicare and multiple state Medicaid. Completes and processes provider enrollment applications for all new department physicians and mid-levels.

• Reviews, monitors and follows up on all items pending for insurance credentialing to ensure providers are payable at start date.

• Completes applications to regularly re-enroll/revalidate providers with state insurance plans as required by each state agency. Annually updates provider licensure information with state agencies to ensure providers remain enrolled.

• Performs follow up activities and projects for outstanding AR, including contacting payers and submitting documentation to facilitate enrollment.

• Provides updates to MSOW via the MSOW provider portal (internal system). Ensures providers are up to date on all practice locations, bill areas, office locations, etc.

• Serves as accountable for initial and continuous verification of credentials of medical staff members, health care/allied health providers for medical staff and managed care providers. Serves as accountable for ensuring ongoing state and federal licensure, compliance with JCAHO and NCQA standards and observance of applicable hospital medical staff by laws and managed care provider contracts and agreements.

• Ensures maintenance of current and accurate data/information in system credentials database. Appropriately utilizes the database to produce reports, lists, rosters, etc., assisting BJC facilities as needed.

• Maintains the permanent credentials files on all applicable medical staff members, managed care and allied health providers. Assures accuracy of records and maintains a state of readiness at all time for review/audit by delegated entities, licensing and accrediting agencies.

• Participates in training and development of HMP personnel on credentialing verification issues.

• Assures the confidentiality and integrity of all aspects of the credentialing verification program and process.

Working Conditions:

Job Location/Working Conditions

• Normal Office Environment

Physical Effort

• Typically Sitting at a desk or table

Equipment

• Office Equipment

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.

Required Qualifications

Education:

High school diploma or equivalent high school certification or combination of education and/or experience.

Certifications:

No specific certification is required for this position.

Work Experience:

Relevant Experience (3 Years)

Skills:

Not Applicable

Driver's License:

A driver's license is not required for this position.

More About This Job

Washington University seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles.

Preferred Qualifications

Education:

No additional education beyond what is stated in the Required Qualifications section.

Certifications:

No additional certification beyond what is stated in the Required Qualifications section.

Work Experience:

No additional work experience beyond what is stated in the Required Qualifications section.

Skills:

Credentialing, Medical Offices, Medical Staff Credentialing

Grade

C08-H

Salary Range

$20.57 - $30.84 / Hourly

The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

Questions

For frequently asked questions about the application process, please refer to our External Applicant FAQ.

Accommodation

If you are unable to use our online application system and would like an accommodation, please email [email protected] or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.

All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.

Pre-Employment Screening

All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.

Benefits Statement

Personal

• Up to 22 days of vacation, 10 recognized holidays, and sick time.

• Competitive health insurance packages with priority appointments and lower copays/coinsurance.

• Want to Live Near Your Work and/or improve your commute? Take advantage of our free Metro transit U-Pass for eligible employees. We also offer a forgivable home loan of up to $12,500 for closing costs and a down payment for homes in eligible neighborhoods.

• WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.

Wellness

• Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!

Family

• We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.

• WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.

For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/

EEO/AA Statement

Washington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

Diversity Statement

Washington University is dedicated to building a diverse community of individuals who are committed to contributing to an inclusive environment – fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.