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Medical Staff Services Coordinator-Full Time

4 months ago

York PA United States OSS Health Full time
JOB SUMMARY:

Under direct supervision from the Manager, Medical Staff Services, assists with the overall day-to-day operations of the OSS Health Medical Staff Office (MSO). Promotes integrity of the department by ensuring compliance with bylaws, rules and regulations established by OSS Health Medical Staff Office and regulatory bodies. Supports the philosophy and goals of OSS Health.

QUALIFICATIONS AND EDUCATION:

Education:

· High School Diploma or GED required; Associate’s or Baccalaureate degree in Business or Healthcare Administration preferred.

Qualifications:

· Progressive credentialing and enrollment experience of a minimum of 3 years required.

· Direct experience in Medical Staff Services and Provider Enrollment is required.

· Certified Provider Credentialing Specialist (CPCS) or Provider Enrollment Specialist Certification (PESC) preferred, but not required.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

· Assists the Manager, Medical Staff Services with planning, organizing and directing the day-to-day operations of the Medical Staff Office (MSO) including staff supervision, staff scheduling and providing consultative expertise to members of the department as needed.

· Maintains New Provider Insurance Par Listing on Internal Webpage and notifies key staff of updates and changes regarding enrollment status.

· Assists the Manager of Medical Staff Services with coordination and integration of services within the department as well as with other departments and facilities.

· Ensures quality control of all Medical Staff Office operations, ensuring timely processing based on all regulatory standards (CMS, DHS, NCQA, and TJC), OSS Health Medical Staff Bylaws and Policies & Procedures.

· Assists the Manager of Medical Staff Services in overseeing the onboarding and off boarding, initial credentialing, re-credentialing, privileging, and provider enrollment operations of OSS Health employed and contracted providers and facility enrollment for all OSS Health locations, including satellite locations and non-OSS Health facilities our providers service, ensuring timely processing based on all regulatory standards, OSS Health Medical Staff Bylaws and Policies & Procedures.

· Maintains the integrity of the Provider’s electronic credentialing and enrollment files at all times.

· Assists the Manager of Medical Staff Services in the final review of all Medical Staff applications prior to Committee Presentation, adhering to all regulatory standards, OSS Health Medical Staff Bylaws and Policies & Procedures.

· Assists the Manager of Medical Staff Services in overseeing facility and provider enrollment with Commercial Insurances, Medicare and Medicaid. Effectively communicates enrollment status to key leadership in Finance and Revenue Cycle.

· Assists the Manager, Medical Staff Services in orienting all new physicians and other credentialed health care providers to the Medical Staff Bylaws, OSS Health policy and procedures to include PDMP registration.

· Coordinates and oversees the onboarding of fellowship and resident providers.

· Conducts, participates in, and maintains current clinical competency evaluations and peer review (FPPE/OPPE):

o Analyzes and prepares provider performance improvement, quality/competence data in clear, concise, and structured reports.

o Recognizes, investigates, and validates discrepancies and adverse information obtained.

o Coordinates an appropriate evaluation by the President of the Medical Staff of gathered data.

o Communicates findings and/or resulting actions to key stakeholders and the practitioner.

· Assists the Manager, Medical Staff Services in coordination and oversight of the Medical Staff Support Specialist’s role in the Physician Licensure and Board CME Oversite Program.

· Manages hospitalist monthly call schedules, scheduling changes and processes, manages, and submits monthly hospital pay details to payroll for payment.

· Analyzes credentialing workflows continuously for modification and improvement.

· Maintains professional growth by participating in educational programs and professional organizations.

· Maintains knowledge of current industry standards, TJC regulations, NCQA regulations, trends, practices and developments.

Assists the Manager, Medical Staff Services in managing and overseeing hiring, training, yearly evaluations and disciplinary functions for personnel in the Medical Staff Office.
Provides leadership and direction to the Medical Staff Office, maintaining a work environment that promotes the creative development of ideas and allows all employees reporting to this position to meet or exceed established standards of performance.

· Provides leadership and direction to the Physical Therapy, DME and Home Health enrollment staff informing them of new payer contracts, completion of their enrollment applications and keeping them apprised of NCQA, CMS, DHS, and military contractor rules and regulation changes.

· Performs other duties that contribute to the overall operation of the organization and department.

SUPERVISORY RESPONSIBILITIES:

Does not formally supervise any positions, but acts as a mentor to department staff and serves as supervisor in the absence of the Manager.

LANGUAGE SKILLS:

Must be proficient in the English language, both verbally and written, in order to communicate effectively with patients, co-workers, physicians, vendors, and the general public.

PHYSICAL DEMANDS:

Sits at desk long periods of time, walks, reaches, lifts, carries and handles light office equipment and materials. May require bending and stooping when lifting or transferring records. Requires fine and gross motor skills, manual dexterity and visual acuity to operate computer and other equipment. Frequently works under pressure to meet deadlines or deal with problem situations. Must have ability to travel between sites and physician offices.

WORK ENVIRONMENT:

Climate controlled environment with occasional periods of being outside.

The above statements reflect the general duties considered necessary to describe the principle functions of the job as identified, and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

#LI-JB1

Experience
Preferred
Direct experience in Medical Staff Services and Provider Enrollment is required.
Progressive credentialing and enrollment experience of a minimum of 3 years required.