Credentialing Supervisor (management Analyst I)

Location
Fairfax, Virginia
Salary
$51,805.31 - $86,341.63 Annually
Posted
May 29, 2021
Closes
Jun 12, 2021
Ref
21-01028
Hours
Full Time
Job Announcement

The Fairfax-Falls Church Community Services Board (CSB) is offering an exciting opportunity for a credentialing professional to join our team. Supporting a team with a diverse pool of clinicians and medical professionals. Credentials and re-credentials all the CSB direct service providers essential for billing. Coordinates with Department of Medical Assistance Services (DMAS) and the Managed Care Organizations (MCOs) to ensure provider and credentialing is completed.

Responsible for all activities associated with credentialing, and re-credentialing of licensed and unlicensed CSB direct care staff for health plans, managed care organizations and third-party payers according to plan specifications and regulations in support of the CBS's revenue management function. Ensures the integrity of the credentialing information in the CSB's electronic health record system by analyzing verification of information and updating Credible on a regular basis. Collaborates with CSB staff and the Revenue Management staff, to communicate and process credentialing updates and changes necessary for credentials and insurance tracking via the CSB's electronic health record. Stays current to remain in compliance with appropriate local, state, national, and federal regulations on credentialing.

Functional areas: Provider Credentialing

Note: To learn more about careers that make a difference, watch our video " CSB: Making a Difference in Our Community ".

Illustrative Duties

(The illustrative duties listed in this specification are representative of the class but are not an all-inclusive list. A complete list of position duties and unique physical requirements can be found in the position description.)
  • Conducts professional-level work in functions or activities, such as financial, budgetary, procurement, contract administration, human resources, training, information technology, and similar functions;
  • Assists with a variety of technical and professional work related to monitoring and reporting on departmental business processes, activities, and outcomes;
  • Performs designated segments of projects or programs with well-defined objectives, including activities such as data collection, synthesis of data gathered to support analysis, and documentation of findings and recommendations;
  • Performs data collection activities in support of existing studies, projects or programs, including conducting research; participating in interviews; administering customer, organizational or employee surveys; assisting in the facilitation of focus groups; participating in work group collaboration; and mapping or charting of workflow processes;
  • Assists with measuring and analyzing indicators of performance, quality, quantity and efficiency of services;
  • Compiles and provides business information to management;
  • Maintains index or log of standard forms for gathering information from a variety of audiences;
  • Formats data sets and performs qualitative and descriptive statistical analysis to aggregate and assimilate data for displaying potential patterns and trends;
  • Assists in implementing business improvements, such as changes to policies, work practices, processes and procedures;
  • Contributes to position papers, evaluation reports and presentations.


Required Knowledge Skills and Abilities

(The knowledge, skills and abilities listed in this specification are representative of the class but are not an all-inclusive list).
  • Basic knowledge of mission, goals and objectives of the organizational unit, program or activities to which incumbent is assigned;
  • Knowledge of the principles, practices and techniques governing management, organization, operations and programmatic services;
  • Knowledge of the principles, practices, and techniques relating to the functional area of business operation (e.g. personnel, budgeting and financial management, contract administration and management);
  • Ability to identify possible solutions for solving business problems;
  • Ability to perform a variety of fact-finding techniques (e.g., interview, case analysis, observation, research, benchmarking) to gather information in support of programs, projects, studies, assessments and evaluations;
  • Ability to aggregate and assimilate data to identify major patterns, trends and themes regarding organizational and program effectiveness and efficiency;
  • Ability to communicate effectively orally and in writing;
  • Ability to use word processing and presentation software to prepare documents, and to use spreadsheet and statistical analysis software packages to store, manipulate, analyze and present data;
  • Ability to train, lead, and/or supervise paraprofessional staff.


Employment Standards

MINIMUM QUALIFICATIONS:
Any combination of education, experience, and training equivalent to the following: g raduation from an accredited four-year college or university with a bachelor's degree in the field related to the assigned functional area.
(Click on the aforementioned link to learn how Fairfax County interprets equivalencies for "Any combination, experience, and training equivalent to")

BRIDGE CLASS EMPLOYMENT STANDARDS
Four years of increasingly complex technical experience in the assigned functional area, comparable to experience at the Admin Assistant IV, or higher, level. This class can serve as a bridge class enabling individuals who do not meet the educational or professional experience standards listed above to qualify for this class by possessing four years of increasingly complex technical experience in the assigned functional area, comparable to experience at the Admin Assistant IV, or higher, level. The purpose of this bridge class is to promote upward mobility within the Fairfax County workforce. However persons qualifying for this class on the basis of their technical experience may not substitute this technical experience for education, or for professional experience, in order to qualify for other employment opportunities.
NECESSARY SPECIAL REQUIREMENTS:
The appointee to this position will be required to complete a criminal background check, a Child Protective Services Registry check, and sanction screening to the satisfaction of the employer. A TB screening upon hire. Positions in this class may be subject to credit checks as a condition of initial or continued employment. This position is emergency/essential services personnel. (Required to report for duty during inclement weather and/or other emergencies).

PREFERRED QUALIFICATIONS:
  • Three (3) or more years of experience in provider/agency credentialing.
  • Eligible for the Certified Provider Credentialing Specialist Certification (CPCS).

PHYSICAL REQUIREMENTS:
Ability to sit, stand, and walk as needed to perform core job functions. Ability to lift up to 25 pounds and travel throughout the county for meetings and meeting with staff as necessary. All duties performed with or without reasonable accommodations.
SELECTION PROCEDURE:
Panel Interview and may include a practical exercise.

Fairfax County Government prohibits discrimination on the basis of race, color, religion, national origin, sex, pregnancy, childbirth or related medical conditions, age, marital status, disability, sexual orientation, gender identity, genetics, political affiliation, or status as a veteran in the recruitment, selection, and hiring of its workforce.

Reasonable accommodations are available to persons with disabilities during application and/or interview processes per the Americans with Disabilities Act. Contact 703-324-4900 for assistance. TTY 703-222-7314. EEO/AA/TTY.

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