Credentialing Coordinator
2 months ago
Position Summary: The Medical Staff Credentialing Coordinator serves as an essential link and resource between the medical staff and hospital management to coordinate the operational processes and medical staff governance functions of the medical staff.
Essential Job Functions and Core Responsibilities:
- Medical Staff Support Management:
- Provide comprehensive management of the medical staff support functions as outlined in the Medical Staff Bylaws and General Rules and Regulations.
- Credentialing and Privileging:
- Perform credentialing and privileging duties, including processing applications for appointment and reappointment, conducting thorough reviews and analyses of practitioner applications, identifying and following up on "red flag" items, and preparing files for medical staff review and recommendation.
- Problem-Solving:
- Utilize excellent problem-solving skills to exercise independent judgment in addressing non-routine medical staff and credentialing concerns.
- Licensure and Certification Management:
- Manage expirations of licensures, permits, certifications, health records, annual dues, and application fees, ensuring the accuracy of all collected information.
- Administrative Support:
- Provide administrative support to the medical staff, including facilitating medical staff department and committee meetings, preparing emergency on-call schedules, maintaining bank account records, and composing correspondences, reports, and forms as needed.
- Reporting and Information Flow:
- Generate queries and prepare credentialing/privileging reports to ensure the flow of information and action items for medical staff committees and the board of directors.
- Compliance and Policy Development:
- Interpret, develop, and initiate processes and policies to ensure compliance with federal, state, local, and government/insurance agency regulations and guidelines, as well as Medical Staff Bylaws, rules and regulations, policies, and procedures. Advise providers, management, and administrators on compliance issues as appropriate.
- Continuing Medical Education Management:
- Manage continuing medical educational activities for physicians to ensure compliance with accreditation standards.
- Privilege Development and Database Maintenance:
- Assist with clinical privilege development and maintain the entity privileging database.
- Administrative/Procedural Decision-Making:
- Make administrative/procedural decisions and judgments in relation to urgent physician privileging matters that impact patient care.
- System-Wide Process Accuracy:
- Ensure the accuracy of system-wide processes and maintain data integrity.
- Office Management:
- Coordinate and participate in daily office management duties, including answering phones, handling incoming and outgoing mail, scanning, filing, distributing information, managing databases, maintaining outlook calendars, ordering supplies, and maintaining storage records.
- Interdepartmental and Medical Staff Interaction:
- Maintain a professional level of interdepartmental and medical staff interaction and accurately maintain department records and confidential physician data and hospital correspondence.
- Special Projects:
- Perform special projects and other duties as assigned.
Qualifications:
- Bachelor’s degree or equivalent experience in a related field.
- Minimum of 3-5 years of experience in medical staff services or credentialing.
- Strong knowledge of medical staff bylaws, credentialing standards, and regulatory requirements.
- Excellent organizational, communication, and problem-solving skills.
- Proficiency in Microsoft Office Suite and credentialing software.
- Ability to manage multiple tasks and projects with a high degree of accuracy and attention to detail.
- Demonstrated ability to handle confidential and sensitive information with discretion.
Benefits:
Benefit offerings include medical, dental, vision, additional voluntary benefits, 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
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