At Children’s Wisconsin, we believe kids deserve the best.

Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Please follow this link for a closer look at what it’s like to work at Children’s Wisconsin: https://www.instagram.com/lifeatcw/

Job Summary

Performs credentialing functions and supports credentialing activities for medical staff, allied health and managed care staff and other health care personnel for CHW and other CHHS entities. Performs high-level confidential duties.

Essential Functions

• Coordinates completion of the credentialing process for new applications and reappointments for all CHHS entities as requested.

• Obtains missing data or information by interacting with various healthcare practitioners, personnel, healthcare organizations as well as through communication with regulatory agencies, primary source verification organizations approved by The Joint Commission and medical liability companies.

• Verifies education and training, performs all Joint Commission approved primary source verification, professional liability, documentation of all claims history, researches open claims, provides the Vice President, Corporate Counsel with required information concerning open claims, NPDB and criminal background checks as part of the appointment or re-appointment application and prepares the files for review, in accordance with Joint Commission Standards and MSO Procedures.

• Coordinates medical staff expirable process.

• Works closely with department leaders and CHW Legal Services to assure that legal requirements are met, appropriate procedures are followed, and that additional information is sought if necessary.

• Understands the importance and critical nature of maintaining accurate provider information and takes responsibility for maintaining the Medical Staff demographic, professional and privilege data in credentialing software.

• According to the medical staff bylaws consistently meets established deadlines through appropriate time management and proper utilization of resources.

• Supports Medical Staff committee(s) as directed by department leaders.

• Maintains a working knowledge of Joint Commission, NCQA and State of Wisconsin credentialing standards, rules and regulations. Continuously seeks out new learning opportunities related to credentialing via use of listserves, reading credentialing materials, networking and working with experienced credentialing staff.

Education

• High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED)

Work Experience

• Physician office or related medical care experience

• Medical staff office experience

• Credentialing experience strongly

• Expertise in medical terminology strongly preferred as demonstrated by medical staff services experience.

• Experience with Microsoft Office products (word, excel, PowerPoint).

Knowledge, Skills and Abilities

• Strong customer service skills that contribute to a customer-oriented team and department.

• Motivated, flexible, and a self-starter.

• Ability to multi-task in a fast-paced environment.

Guiding Behaviors

• Exhibits guiding behaviors that reflect Children's values and support our mission and vision

Working Conditions

This job primarily operates in a setting that routinely requires use of standard office equipment and/or where there is no reasonable potential for exposure to blood and other high risk body fluids.

Required for All Jobs

• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.

• Employment is at-will. This document does not create an employment contract, implied or otherwise.

Fully Remote Work Opportunity

Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

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