Job Description
About Us:
At Sinai Chicago, we take health care personally. Excellence in health care is about more than just medicine, technology, tests and treatments, it is about really caring for people with dignity and respect. That’s what we do. We are dedicated to providing the best care to meet the needs of people, for our community, for our patients and for you.
Position Purpose:
The Provider Credentialing Assistant supports the Network Development Team, Central Scheduling, Revenue Cycle, and Decentralized Departments according to the bylaws, policies, and other regulatory requirements to ensure that all providers are correctly loaded into Epic. This role also maintains and update existing data by proactively verifying all providers with the designated point of contact regularly.
Key Job Activities:
• Gathers, verifies, and maintains all required data to determine applicants' eligibility to be credentialed.
• Examines application for completeness and identify any missing data elements.
• Conducts follow-up on identified adverse data elements.
• Identifies all practice locations for each applicant.
• Determines when the credentialing process is complete.
• Submits and maintains any relevant data into appropriate databases.
• Assures every employed physician is credentialed with each Health Plan.
• Oversees and works on the assigned list of Providers Not on File requests for upload to EPIC Dictionary.
• Tracks all internal and external Help Desk Tickets from Open to Close to ensure a timely resolution.
• Functions as a subject matter expert related to all duties pertaining to Ordering Provider EPIC Dictionary.
• Provides efficient maintenance and ensures the accuracy of provider databases as it pertains to provider dictionary.
• Reconciles and updates any necessary accounts that may have been impacted by delayed processing of provider data. This may include updating pre-service appointments with the loaded provider information, in addition to updating post-service updates with correct provider information.
• Works interdepartmentally and externally to ensure that all billing errors related to provider profiles are reconciled and resolved.
• Ensures that provider-related databases and billing are consistently maintained at an accuracy level of +5% or above as a Key Performance Indicator.
• Performs other duties as assigned.
Education and Work Experience:
• High school diploma/GED required, associate degree preferred.
• 2+ years of previous work-related credentialing experience
• 2+ years in Revenue Cycle management/billing
Knowledge and Skills:
• 1+ years’ experience in EPIC and MEDITECH software systems required.
Certifications/Licenses:
• None
Workplace Conditions:
PHYSICAL DEMANDS:
• While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle or feel; and talk or hear
• The employee frequently is required to walk and stoop, kneel, crouch
• The employee is occasionally required to stand • The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus
• WORK ENVIRONMENT:
• General office environment and the noise level in the work environment is usually moderate
BLOOD-BORNE PATHOGEN EXPOSURE CATEGORY:
Category 1 - Job usually involves contact with patients or patient’s specimens. Exposure to blood, body fluids, non-intact skin or tissue specimens, is possible
Category 2 - Job may expose incumbent occasionally or in emergency situations to blood, body fluids, non-intact skin or tissue specimens
xCategory 3 - Job does not involve exposure to blood, body fluids, non-intact skin or tissue specimens. Incumbent does not perform or help in emergency medical care or first aid as a part of his/her job.
Benefits:
Sinai Health System’s goal is to provide you with the most comprehensive benefit package possible while balancing our fiscal commitments and obligations. Sinai Health Systems currently offers its employees the option to participate in a full range of benefits, including a health care program which includes medical, dental, vision and prescription coverage. Along with Employer Paid Life and Accidental Death & Dismemberment (AD&D), Supplemental Life, Short-Term and Long-Term Disability, Health Savings Account (HSA) and Flexible Spending Account (FSA), Employee Assistance Program and Student Loan Assistance. Participation in some programs requires that employees be regularly scheduled to work a minimum number of hours and/or to have fulfilled a waiting period after they begin employment with Sinai Health Systems. Registry (per diem) Caregivers are caregivers who work less than 1,000 hours in a calendar year. Registry caregivers are employees of Sinai Health System but are typically on an as needed basis. These caregivers may be called upon to cover full-time or part-time caregivers during PTO events or sick leave as well as to provide sinaichicago.org supplemental coverage.
Registry Caregivers are not eligible for Sinai’s benefit programs with the exception for Sick-C, PPO Medical Plan, Employee Assistance Program (EAP) and non-match eligible contribution to the Sinai Health System Consolidated 403(b) retirement savings plan.
Living the Values:
• TEAMWORK - Caregiver works together with other caregivers to create and maintain an inclusive workplace where differences, inclusivity, conflict resolution and open communication are valued
• RESPECT - Caregiver shows mutual respect and fairness, treats each person with dignity and encourages each individual’s unique talents and contributions
• QUALITY - Caregiver improves our services by following protocol and suggesting improvements based on observations, continuous learning and industry best practices
• INTEGRITY - Caregiver holds self and others accountable for their actions and are honest and ethical in all dealings
• SAFETY - Caregiver practices behaviors that promote safety for all patients, visitors, and caregivers
• ROLE MODEL - Caregiver is a dependable role model and champions our values through their daily interactions with patients, customers and coworkers
At Sinai Chicago, we take health care personally. Excellence in health care is about more than just medicine, technology, tests and treatments, it is about really caring for people with dignity and respect. That’s what we do. We are dedicated to providing the best care to meet the needs of people, for our community, for our patients and for you.
Position Purpose:
The Provider Credentialing Assistant supports the Network Development Team, Central Scheduling, Revenue Cycle, and Decentralized Departments according to the bylaws, policies, and other regulatory requirements to ensure that all providers are correctly loaded into Epic. This role also maintains and update existing data by proactively verifying all providers with the designated point of contact regularly.
Key Job Activities:
• Gathers, verifies, and maintains all required data to determine applicants' eligibility to be credentialed.
• Examines application for completeness and identify any missing data elements.
• Conducts follow-up on identified adverse data elements.
• Identifies all practice locations for each applicant.
• Determines when the credentialing process is complete.
• Submits and maintains any relevant data into appropriate databases.
• Assures every employed physician is credentialed with each Health Plan.
• Oversees and works on the assigned list of Providers Not on File requests for upload to EPIC Dictionary.
• Tracks all internal and external Help Desk Tickets from Open to Close to ensure a timely resolution.
• Functions as a subject matter expert related to all duties pertaining to Ordering Provider EPIC Dictionary.
• Provides efficient maintenance and ensures the accuracy of provider databases as it pertains to provider dictionary.
• Reconciles and updates any necessary accounts that may have been impacted by delayed processing of provider data. This may include updating pre-service appointments with the loaded provider information, in addition to updating post-service updates with correct provider information.
• Works interdepartmentally and externally to ensure that all billing errors related to provider profiles are reconciled and resolved.
• Ensures that provider-related databases and billing are consistently maintained at an accuracy level of +5% or above as a Key Performance Indicator.
• Performs other duties as assigned.
Education and Work Experience:
• High school diploma/GED required, associate degree preferred.
• 2+ years of previous work-related credentialing experience
• 2+ years in Revenue Cycle management/billing
Knowledge and Skills:
• 1+ years’ experience in EPIC and MEDITECH software systems required.
Certifications/Licenses:
• None
Workplace Conditions:
PHYSICAL DEMANDS:
• While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle or feel; and talk or hear
• The employee frequently is required to walk and stoop, kneel, crouch
• The employee is occasionally required to stand • The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus
• WORK ENVIRONMENT:
• General office environment and the noise level in the work environment is usually moderate
BLOOD-BORNE PATHOGEN EXPOSURE CATEGORY:
Category 1 - Job usually involves contact with patients or patient’s specimens. Exposure to blood, body fluids, non-intact skin or tissue specimens, is possible
Category 2 - Job may expose incumbent occasionally or in emergency situations to blood, body fluids, non-intact skin or tissue specimens
xCategory 3 - Job does not involve exposure to blood, body fluids, non-intact skin or tissue specimens. Incumbent does not perform or help in emergency medical care or first aid as a part of his/her job.
Benefits:
Sinai Health System’s goal is to provide you with the most comprehensive benefit package possible while balancing our fiscal commitments and obligations. Sinai Health Systems currently offers its employees the option to participate in a full range of benefits, including a health care program which includes medical, dental, vision and prescription coverage. Along with Employer Paid Life and Accidental Death & Dismemberment (AD&D), Supplemental Life, Short-Term and Long-Term Disability, Health Savings Account (HSA) and Flexible Spending Account (FSA), Employee Assistance Program and Student Loan Assistance. Participation in some programs requires that employees be regularly scheduled to work a minimum number of hours and/or to have fulfilled a waiting period after they begin employment with Sinai Health Systems. Registry (per diem) Caregivers are caregivers who work less than 1,000 hours in a calendar year. Registry caregivers are employees of Sinai Health System but are typically on an as needed basis. These caregivers may be called upon to cover full-time or part-time caregivers during PTO events or sick leave as well as to provide sinaichicago.org supplemental coverage.
Registry Caregivers are not eligible for Sinai’s benefit programs with the exception for Sick-C, PPO Medical Plan, Employee Assistance Program (EAP) and non-match eligible contribution to the Sinai Health System Consolidated 403(b) retirement savings plan.
Living the Values:
• TEAMWORK - Caregiver works together with other caregivers to create and maintain an inclusive workplace where differences, inclusivity, conflict resolution and open communication are valued
• RESPECT - Caregiver shows mutual respect and fairness, treats each person with dignity and encourages each individual’s unique talents and contributions
• QUALITY - Caregiver improves our services by following protocol and suggesting improvements based on observations, continuous learning and industry best practices
• INTEGRITY - Caregiver holds self and others accountable for their actions and are honest and ethical in all dealings
• SAFETY - Caregiver practices behaviors that promote safety for all patients, visitors, and caregivers
• ROLE MODEL - Caregiver is a dependable role model and champions our values through their daily interactions with patients, customers and coworkers
💡 Quick Summary
Seeking a career-building opportunity? The Provider Credentialing Assistant position is now open for candidates interested in the Health Jobs sector. This role in Chicago offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Health Jobs is a plus.
