Who We Are
We are Imagine Pediatrics, a devoted and compassionate pediatrician-led medical group that is creating the world our sickest children deserve. Founded on the belief that medically complex children deserve better care than the current system allows for, we deliver personalized and comprehensive care by partnering with families to provide unparalleled support, virtually and in-home, ensuring they spend more time in their homes and less in the hospital.
What We Live By
We're guided by our five core values:
- Children first. We put the best interests of children above all. We are uncompromising in our commitment to improving the lives of children and families by bringing the best care to them.
- Earn trust. We cherish the trusting relationships we build with the children and families we serve, our partners, and each other. We seek first to understand and speak honestly.
- Innovate today. We refuse to accept the way things have always been done. Children and families are waiting for our help and their bravery demands that we relentlessly challenge assumptions to develop new approaches.
- Embrace humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to learn and grow stronger.
- One team, diverse perspectives. We work alongside families as one team towards a shared purpose. We champion diversity and acknowledge the contributions of others.
What You'll Do
- Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, local and University regulations, guidelines, policies, and standards.
- Conducts primary source verification, collects, and validates documents to ensure accuracy of all credentialing elements; assesses completeness of information and qualifications relative to credentialing standards and Imagine Pediatrics criteria.
- Identifies, analyzes, and resolves extraordinary information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners; discovers and conveys problems to CVO Credentialing Manager and entity Medical Staff Affairs for sound decision making in accordance with Medical Staff Bylaws, credentialing policies and procedures, federal, state, local and government/insurance agency regulations.
- Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate.
- Enters, updates, and maintains data from provider applications into credentialing database, focusing on accuracy, and interpreting or adapting data to conform to defined data field uses, and in accordance with internal policies and procedures.
- Prepares, issues, electronically tracks and follows-up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines.
- Participates in the development and implementation of process improvements for the system-wide credentialing process; prepares reports and scoring required by regulatory and accrediting agencies, policies, and standards.
- Communicates clearly with providers, their liaisons, entity Medical Staff Affairs. medical staff leadership and Administration, as needed to provide timely responses upon request on day-to-day credentialing and privileging issues as they arise.
- Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest developments to enhance understanding of various regulations and legislation of the health care industry.
- Performs miscellaneous job-related duties as assigned.
- Prepares and submits payer enrollment applications directly to payers.
- Gathers any additional data and/or documents from providers to facilitate enrollments.
What You Bring & How You Qualify
- High school diploma or GED; at least 2 years of experience directly related to the duties and responsibilities specified.
- Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.
- Ability to communicate effectively both orally and in writing.
- Customer service skills.
- Ability to respond to emails timely and effectively.
- Information research skills.
- Knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures, and documentation.
- Working knowledge of clinical and/or hospital operations and procedures.
- Ability to use independent judgment and to manage and impart confidential information.
- Ability to maintain confidentiality and discretion in all communications on behalf of credentialing applicants and/or applications.
- Ability to make administrative/procedural decisions and judgments.
- Demonstrated advanced working knowledge of Microsoft Word and Excel.
- Ability to learn new applications to function effectively in a remote work environment.
- Skill in establishing priorities with independent coordination of day-to-day aspects.
- Advanced skills in computerized spreadsheeting and database management.
- Willingness to grow and lean all components of the healthcare revenue cycle.
What We Offer (Benefits + Perks)
The target base salary for this position ranges from $50,000 to $65,000 in addition to competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary.
We provide these additional benefits and perks:
- Full medical, dental, and vision insurance
- Healthcare and Dependent Care FSA
- 401(k) with 4% match, vested 100% from day one
- 20 days PTO + 10 Company Holidays & 2 Floating Holidays
- Paid parental leave + Fertility benefit.
- Pet Insurance
- Additional benefits to be detailed in offer.
We Value Diversity, Equity, Inclusion and Belonging
We believe that creating the world our sickest children deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
