We are recruiting for a motivated Auditor, Provider Enrollment and Credentialing to join our team!
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Department
Medical Staff Services and Provider EnrollmentJob Summary
Under minimal supervision, ensures credentialing and privileging activities of the Medical Staff Services and Provider Enrollment Teams comply with requirements of regulatory and accrediting agencies including the Centers for Medicare/Medicaid Services, the Joint Commission, and the National Committee for Quality Assurance, federal and state laws and delegated credentialing agreements independently.
Essential Functions:
Audits credentials files and verifies information entered in information systems (50%)
Maintains and analyzes quality data, identifies trends, and recommends corrective actions (10%)
Coordinates external audit engagements and responding to complex inquiries (5%)
Prepares and submits material for external audits and Corrective Action Plans (5%)
Works with Coordinators in Medical Staff and Provider Enrollment to ensure audit results are identified, shared and monitored for continued compliance (10%)
Works with Departments/Divisions to maintain monthly rosters and to ensure all data elements are captured appropriately (15%)
Assist in the maintenance of information flowing between MD Staff and EPIC to be correct (5%)
Education:
High School Diploma or GED Graduation from High School or equivalent required Required
Work Experience:
4-6 years Five years of relevant experience in Medical Staff credentialing & privileging and/or Provider Enrollment Required
Licenses:
Knowledge, Skills and Abilities:
MD Staff knowledge is preferred
Computer proficiency in Windows, Microsoft Office, and Internet
Knowledge of TJC, NCQA and CMS credentialing and enrollment standards
Ability to handle multiple tasks, simultaneously
Ability to interpret and apply policies and procedures
Ability to communicate in a professional and positive manner
Must be able to work independently and meet schedules and deadlines
Shift
Days (United States of America)
Work Type
Regular
Salary
$28.99 - $42.16 / hr
Benefits
Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans
Free RTD EcoPass (public transportation)
On-site employee fitness center and wellness classes
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education & development opportunities including career pathways and coaching
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer
Our Values
Respect
Belonging
Accountability
Transparency
All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver?s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.
As Colorado?s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).
Take your career to the next level at Denver Health, where we offer a robust benefits package and endless opportunities for growth. Denver Health is a nationally-ranked, locally-trusted, premier healthcare institution located in the heart of Denver, Colorado.Twenty-five percent of all Denver residents, or approximately 150,000 individuals, receive their health care here. We are known as an integrated health care system that encompasses multidisciplinary academic specialties, a community health system, a level I adult trauma center, pediatric emergency and urgent care center home to Denver Public Health and many of the nation's leaders in medicine.Denver Health is an Equal Opportunity Employer At Denver Health we pride ourselves on our commitment to diversity. Equal opportunity is a fundamental principle of Denver Health. As an equal opportunity employer, Denver Health is committed to recruit, hire, promote and administer all human resource actions in a non-discriminatory manner. Denver Health is committed to providing equal opportunities in all business practices and to all persons regardless of age, race, color, national origin, genetic information, religion, sex, pregnancy, disab...ility, sexual orientation, gender identity, gender expression, marital status or veteran status (collectively “protected status”). Denver Health strives to maintain a work environment that is free from unlawful harassment and discrimination and will not tolerate any such conduct by employees or directed at employees within the scope of their employment. Read the full Human Resources Employee Principles and Practices policy.