Credentialing & Privileging Specialist Job at KMRG LLC, Johnston, IA

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  • KMRG LLC
  • Johnston, IA

Job Description

ROLE We are seeking a skilled Credentialing & Privileging Specialist to support the Iowa Army National Guard (IAARNG) Army Medical Detachment (AMEDD) in Johnston, IA. Your responsibilities will focus on coordinating provider credentialing, tracking medical readiness, and supporting statewide clinical scheduling and reporting in accordance with Army National Guard medical standards. This is a full-time opportunity in which we'll provide competitive pay, comprehensive benefits, and job stability and security. Apply today!

RESPONSIBILITIES

I. Medical Readiness Functions Perform service without direct supervision in accordance with applicable Army medical readiness standards Enter data into the Medical Operational Data System (MODS) and the Medical Protection System (MEDPROS) Make administrative decisions on sensitive or confidential issues and maintain confidentiality of records Interpret policies and regulations concerning the release of protected medical information Resolve issues with data input, storage, or retrieval and escalate unresolved issues appropriately Design or recommend process improvements to support system accuracy and data integrity Communicate effectively both verbally and in writing in a professional environment Develop efficient processes for tracking and processing clinical documentation Organize files and tasks in a structured and accessible manner Adapt to changing priorities and multitask to support medical readiness requirements Support the Deputy State Surgeon, Medical Records Manager, and Medical Records Custodian in achieving statewide readiness objectives II. Training Attend scheduled MODS training and instruct all seven module areas to Army National Guard personnel Update the Deputy State Surgeon and Operations Officer in Charge on training requirements for Active Guard Reserve (AGR), Active-Duty Operational Support (ADOS), civilian technicians, and contractors Track system access and training status for statewide staff and report monthly training needs III. Data Analysis Maintain data files in MODS and MEDPROS and update taskforces and immunizations after clinical events Analyze data for accuracy and compatibility and resolve routine coding issues with staff Investigate discrepancies, run reports, and prepare data summaries for leadership IV. Reporting Submit monthly reports detailing medical records activity and system updates Prepare reports for Periodic Health Assessment, Post-Deployment Health Readiness Assessment (PDHRA), immunizations, dental compliance, and unit readiness Audit records, verify report data, and submit documentation to leadership upon request Ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Act and respond to data requests per policy V. Credentialing Verify provider credentials through primary source checks Coordinate with healthcare providers to collect documentation and maintain a current credentialing database Generate Interfacility Credentials Transfer Briefs (ICTBs) for providers assigned outside Iowa Train providers annually on credentialing and privileging processes Participate in monthly teleconferences with the third-party credentialing contractor VI. Readiness Scheduling Coordinate with staff and external providers to schedule statewide Periodic Health Assessment (PHA) events Book appointments for individual Soldiers for physicals, Soldier Readiness Processing (SRP), and clinical exams Issue vouchers for dental services and specialized hearing assessments VII. Dental Coordination Act as primary liaison for dental treatment contractors and attend dental events to support execution Check in patients at treatment events and track no-shows, refusals, and follow-up voucher needs Report dental treatment status and event outcomes to the Deputy State Surgeon KNOWLEDGE & SKILLS Knowledge of Department of Defense (DoD) and Army regulations related to medical readiness requirements Knowledge of policies governing provider credentialing and privileging in military healthcare environments Knowledge of military medical systems such as MEDPROS, MODS, and MEDCHART Knowledge of system access protocols, protected health information, and data security standards Skilled in performing credentialing and readiness coordination tasks independently without direct supervision Skilled in interpreting regulatory guidance and applying it to medical readiness procedures Skilled in resolving data input, retrieval, and system functionality issues within secure platforms Skilled in addressing confidentiality concerns and resolving discrepancies involving sensitive information Ability to maintain current understanding of evolving systems, policies, and procedures Ability to identify data inconsistencies and implement appropriate corrective actions Ability to troubleshoot reporting errors and collaborate with staff to resolve technical issues Strong judgment and discretion when working with confidential provider records and Soldier readiness data PREFERRED EXPERIENCE Two (2) years of MEDCHART/MODS experience Three (3) years of experience and demonstrated capability in program or project coordination Experience in healthcare credentialing Experience in medical readiness reporting Experience working in military or secure healthcare environments EDUCATION High school diploma or equivalent required Bachelor's degree in health administration preferred LOCATION Johnston, Iowa 50131 TELEWORK Not eligible for telework CLEARANCE U.S. citizenship is required as it supports the U.S. federal government CLIENT Department of the Army TRAVEL Travel is required WORK HOURS 40 hours 8 hours a day 5 days a week EMPLOYMENT CLASSIFICATION Employment Classification Eligibility - Nonexempt RELOCATION Not eligible for relocation benefits ****************** KMRG, LLC is an Equal Opportunity/Affirmative Action (EEO/AA) employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex, gender identity, sexual orientation, ancestry, national origin, age, marital or civil partnership status, mental disability, physical disability, medical condition, pregnancy, maternity status, political affiliation, military or veteran status, genetic information, traits historically associated with race, or any other basis prohibited by federal, state, and/or local law. Other Considerations. Applicants will be subject to a background investigation. Individual's primary workstation is located in an office area. The noise level in this environment is low to moderate. Regularly required to sit for extended periods up to 100% of the time; frequently required to move about to access file cabinets and use office equipment such as PC, copier, fax, telephone, cell phone, etc. Occasionally required to reach overhead, bend, and lift objects of up to 10 lbs. Specific vision abilities required by this job include the use of computer monitor screens up to 100% of the time. KMRG LLC

Job Tags

Full time, For contractors, Civilian Contractor, Work at office, Local area, Relocation, Relocation package,

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