Medical Staff Credentialing Coordinator

Default Work Shift:

Day (United States of America)

Hours:

40

Salary range:

$29.14 - $44.26

Schedule:

Full Time

Shift Hours:

8 Hour employee

Department:

Medical Staff

Job Objective:

Responsible for credentialing and privileging activities of the medical staff and advanced practice providers (APP). Serves as a primary resource and liaison for the medical staff and advanced practice providers and department chairs, medical staff officers and committee chairs. Responsible for coordination of the Credentials Committee and Interdisciplinary Practice Committee including: agendas, minutes, and follow-up correspondence and activities. Oversees the credentialing processes to assure compliance with all applicable regulatory standards and medical staff requirements. Working knowledge of the Medical Staff Bylaws, The Joint Commission and State and Federal Regulations.

Job Description:

Education:
Required: Bachelor's degree

Licensure/Certification:
Required: Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM)

Experience:
Required: Three (3) years in a hospital medical staff office performing duties representative of this position

Reports To: Director-Medical Staff Services Supervises: N/A Ages of Patients: N/A Blood Borne Pathogens: Minimal/ No Potential

Skills, Knowledge, Abilities:

Ability to create, generating, and amending reports from various databases, Ability to critically analyze primary source data as received, Ability to organize and manage a large volume workload, Ability to recommend improvements to software, Comprehensive knowledge of medical staff credentialing & privileging platform, Comprehensive knowledge of medical staff-related databases and electronic management of credentialing data/information, Comprehensive knowledge of physician and advanced practice providers credentialing and privileging, for initial applications, reappointment applications, change in location/duties, additional privilege requests, locum tenens requests, and temporary privileges requests, Working knowledge of Medical Staff, federal and state regulatory requirements, Medical Staff Bylaws, General Medical Staff Rules & Regulations, Departmental Rules & Regulations and certification requirements, Written and verbal communication skills

Essential Responsibilities

1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations. 2. Coordinates credentialing process for initial appointment and reappointment of physicians and advanced practice providers (APP) and locum tenens. Responsible for ensuring applicant’s qualifications meet or exceed established guidelines set by the medical staff and all required information is verified prior to review by Section Chiefs/Department Chairs and submission to Credentials Committee or Interdisciplinary Practice Committee. 3. Evaluates primary source responses and alert applicable leaders as red flags are identified to ensure any additional follow-up is performed timely and there are no surprises that would delay a provider beginning to work. 4. Ensures all reappointments are completed according to schedule and do not exceed the two-year reappointment period as specified by the Joint Commission/CMS. 5. Ensures competency requirements set by Departments and/or Specialty sections are adhered to by all practitioners; following up when necessary to gather applicable support documentation. 6. Prepares and processes Temporary Privilege requests when applicable. 7. Serves as primary liaison to Department Chairs and Section Chiefs. 8. Updates practitioner demographic information as applicable to ensure integrity of the medical staff credentialing database and assures quality and accuracy of data. 9. Prepares Credentials and Interdisciplinary Practice meeting minutes, confidential correspondence, and follow-up. 10. Prepares Credentials and Interdisciplinary Practice reports to MEC/BOD. 11. Monitors licensures/certificates, malpractice, sends reminder notices, and updates ECHO database with renewals prior to expiration. 12. Coordinates New Physician Orientation process by notifying practitioners, preparing orientation manuals, facilitating physician lab coats, photo ID with HR, etc. 13. Prepares updates to Reappointment Schedules as specialty cycles are completed. 14. Prepares BOD approval letters based on Credentials report. 15. Participates and contributes to quality improvement activities of the department. 16. Researches new technology and new privileges to the organization to assist with the development of criteria and collaborate with IT to e