Save Job Job Saved
Welcome to Winchester Hospital, part of Beth Israel Lahey
Health. Winchester Hospital was the first hospital in Massachusetts
to earn Magnet recognition, the American Nurses Association's
highest honor for nursing excellence, three times. It has since
received the recognition a fourth time. As the northwest suburban
Boston area's leading provider of comprehensive health care
services, the 229-bed facility provides care in general, bariatric
and vascular surgery, orthopedics, pediatrics, cardiology,
pulmonary medicine, oncology, gastroenterology, rehabilitation,
radiation oncology, pain management, obstetrics/gynecology and a
Level IIB Special Care Nursery.
About the Job
JOB SUMMARY: Contributes to the Hospital's mission by verifying
physician's applications for privileges and conducting background
checks to ensure our physicians meet the health plans' competency
standards. Processes paperwork and enrollment applications for
physicians and other credentialed providers in WPA, Winchester
Healthcare Enterprises, and other Winchester Hospital affiliated
entities and payor plans under contract with WPA. This
administrative compliance position will have an impact on patient
safety and physician engagement and satisfaction by
appointing/reappointing providers, and improving the speed by which
physicians are activated by payor plans.
Required: High School Diploma or equivalent
Preferred: Associates degree in healthcare or business
Required: At least one year provider credentialing
Preferred: Experience in Medical Staff Office or experience
working with physicians
- For safety and quality reasons, must be able to read, write and
communicate effectively in English with patients, visitors and
fellow members of the hospital team.
- Proficient in word processing, Excel, Internet and database
- Excellent organization, communication and customer service
LICENSES, REGISTRATIONS, CERTIFICATIONS:
Preferred: Certified Professional Credentials Specialist
LIFE SUPPORT CERTIFICATION REQUIRED: N/A
POPULATION SPECIFIC REQUIREMENTS: N/A
OTHER JOB REQUIREMENTS:
Professional Commitment Requirements: Keep abreast of
developments in the field and/or licensure through continuing
education, participation in professional organizations or a
combination of both.
On-call Requirement: None
Schedule Requirements: General business hours, schedule may vary
based on business needs.
Travel Requirements: Based on business needs to better service
- Reports to Billing Manager
- Not responsible for supervising the work of others.
As part of the Physician Billing Services team, this
- Coordinates the credentialing process for physicians and other
credentialed providers in WPA, Winchester Healthcare Enterprises,
and other Winchester Hospital affiliated entities by using the
Board of Registration in Medicine guidelines.
- Reviews appointment/reappointment applications for
completeness, verifies accuracy of required information.
Differentiates between credentialing requirements for various
- Contacts practitioner to inquire about missing information
and/or discrepancies and keep abreast of status.
- Inputs information into credentialing software.
- Maintains accurate and up-to-date practitioner files.
- Generates required verification letters to ensure verification
process proceeds within established time limits.
Payor Plan Enrollment:
- Processes enrollment applications in a manner of superior
customer service to our physicians. While recognizing that
ultimately the accuracy and completion of these forms are the
physician's responsibilities, does all possible to streamline and
ease the process for the physicians, our customers.
- Investigates application processing conflicts and delays to
expedite applications and minimize future problems.
credentialing or enrollment.
- Maintains electronic and paper documentation as it relates to
- Continually investigates insurance companies' websites for
procedures and requirements.
- Investigates and resolves credentialing/enrollment related
- Assists with other projects and duties as assigned.
40 hours, full time
Beth Israel Lahey Health is dedicated to improving health and
wellness and making a difference in the lives of our patients,
their families and all members of the communities we serve. Formed
in March 2019, Beth Israel Lahey Health is a patient-centered,
integrated care delivery system providing a continuum of services
spanning academic, tertiary and community hospitals, dedicated
orthopedic and psychiatric hospitals, primary and specialty care,
community acute care, ambulatory care, behavioral services and home
health. Beth Israel Lahey Health Performance Network is a unified
joint contracting and population health management organization,
jointly governed by participating physicians and hospitals.