Clinical Documentation & Credentialing Spc.
Company: ELITE DENTAL PARTNERS L
Location: Chicago
Posted on: March 20, 2023
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Job Description:
Job Title:Clinical Documentation and Credentialing
SpecialistSupervisory Role:NoExemption Status:Non-ExemptDate
Created/Revised:March 17, 2023 JOB SUMMARY The Clinical
Documentation and Credentialing Specialist will assist Elite's
Legal Team to ensure we collect and verify all required
documentation from new or rehired clinicians before they begin or
resume treating patients at our practices. This team member will
have direct and consistent communication with providers throughout
the offer, hiring and onboarding process to facilitate and ensure
compliance with Elite Dental Partners' documentation requirements.
The documents will be securely stored and updated as expiration
dates approach. The Clinical Documentation and Credentialing
Specialist will be responsible for collection of all required
documents and information, including the items listed below and any
other documentation which is deemed necessary. Required
Documentation (dentist and/or hygienist)Required Information and
VerificationDental or Hygiene License (& licenses in other
states)DiplomaCV (current/updated)DEA Certificate CDS (State
Controlled Dangerous Substance)CPR & BLSAnesthesia License *Nitrous
Certification (per state) *Specialty Certificate *Residency
Certification & Information *Board Certification *Malpractice
Coverage Sheet (from Compliance Dept)Malpractice/Dental License
Narrative *Name Change Information *Work Gap History & Explanation
* Background check (history and criminal - coordinate with
recruiting department if this is already being run)NPDB
(healthcare-specific background check)SAMS (Medicare/Medicaid
conflicts)OIG (Fraud, Waste & Abuse Violations)Type 1 Provider NPI
(confirmed on NPPS database and matching name on dental
license)CAQH Provider Acknowledgement form, updated CAQH Profile &
related informationProvider Digital Signature (in
Credentialing/Compliance software)* If applicable Documentation
must be verified through the proper channels; as well as checked
for accuracy and legibility. A copy of the actual document must be
obtained for Elite's files. The Clinical Documentation and
Credentialing Specialist will need to maintain familiarity with the
documents and information and become a resource to explain what is
needed and answer clinicians' questions throughout the process. A
candidate with a working knowledge of regulatory compliance
standards including: OSHA, CDC, HIPAA, EPA, FDA and all Federal and
State standards applicable to the dental setting would be a good
fit for this role. This position reports directly to the General
Counsel or Vice President of Payor Contracting and works in close
partnership with our doctors and hygienists; as well as the legal,
compliance and insurance credentialing teams. To perform this job
successfully, an individual must be able to perform each of the
essential job duties satisfactorily. The requirements listed below
are representative of the knowledge, skills, and/or ability
required. ESSENTIAL JOB RESPONSIBILITIESEnsure Elite Dental
Partners' required documentation is collected from all clinicians
as necessary before employment start dateBuild partnerships and
maintain regular communication with clinicians, Legal, Compliance,
and Insurance Credentialing Teams to ensure open communication and
cooperationBe aware of regulatory developments and quickly adapt
documentation requirements, as neededMaintain accountability for
the process of clinician documentation and information collection
prior to the employment start dateSecurely store provider
information in a document libraryTrack expiring documents and
collect updates from the provider before expiration date is
finalCompetently utilize Excel and Credentialing software to upload
clinician information and documents, as well as track
expirablesConduct video calls through Teams with new clinicians to
walk them through the document collection process as neededEscalate
any issues with non-compliant providers or missing documentation to
the Compliance Team (failing to comply with documentation and
information requests will likely delay the provider's start
date)Maintain relationship with Recruiting, Operations, and Locum
and Temp agencies and ensure that any clinician hired, even on a
temporary basis, has the documentation required to work at one of
Elite Dental Partners' locations before start date of employment
OTHER JOB RESPONSIBILITIESIdentify and evaluate alternate methods
for the document collection and verification process and
improvements to the documentation collection and credentialing
processAccept other responsibilities as assigned by General Counsel
or Vice President of Payor Contracting EDUCATION AND EXPERIENCE 5+
years in dentistry preferredHealthcare/dental safety and compliance
experience Regulatory knowledge preferred Excellent communication
skills Proficiency with Excel The above statements are intended to
provide a general overview and level of work being performed by
most people assigned to this job. They are not intended to be a
list of all responsibilities, duties and requirements. Additional
duties can be assigned as determined.Elite Dental Partners is an
Equal Opportunity Employer. We support a diverse workforce.
PI208459783
Keywords: ELITE DENTAL PARTNERS L, Chicago , Clinical Documentation & Credentialing Spc., Healthcare , Chicago, Illinois
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