Medical Staff Office Credentialing Specialist-FullTime

4 weeks ago

Idaho Falls, United States Mountain View Hospital Full time
Job Details

Level
Entry

Job Location
Hospital Main Campus - Idaho Falls, ID

Position Type
Full Time

Education Level
High School

Job Category
Admin - Clerical

Description

Mountain View Hospital is looking for a Credentialing Specialist to join our team

JOB SUMMARY:

Ensure all members of the Mountain View Hospital medical staff are compliant according to Idaho CMS standards and the Rules and Regulations of Mountain View Hospital. Credential all new provider files for Mountain View Hospital's Credentialing Committee and Board of Managers. Complete bi-annual re-credentialing requirements of existing staff members. Prepare all documentation and materials needed for medical staff evaluations and review processes. Assist in medical staff management when needed. Monitor all providers within facility and those requesting patient information outside of the facility. Assist in quality assurance and compliance measures by tracking and standardizing all orders and forms within the facility. Assist the compliance department with all data collection, data reporting and statistical evaluations.

BENEFITS:

Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:
  • Medical, Dental and Vision Insurance
  • Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
  • Retirement Plans (401K with up to 6% match)
  • Earned Quarterly Bonus Program
  • Education Reimbursement Program
  • Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.

DUTIES AND RESPONSIBILITIES:

1. The Credentialing Specialist will perform a variety of duties, including, but not limited to:
a. Compilation of initial and re-credentialing packets.
b. Distribution of initial and re-credentialing packets.
c. Verify all providers outside affiliations and peer evaluations.
d. Gather all required medical licensure, certificates of education, board certifications, continued medical education (CME) credits, and health background information.
e. Search National Practitioner Data Bank, America Medical Association and any other investigative agencies for further provider information.
f. Review all credentialing files with Chief Compliance Officer prior to Credentialing Committee.
g. Review files with Chief of Medical Staff when asked to do so.
h. Prepare all documentation for Mountain View Hospital Credentialing Committee and Board of Managers.
i. Inform all initial and re-credentialed applicants of staff status once Board of Managers is completed.
j. Update provider's information in hospital databases including physician database, intranet, CPSI.
k. Create, disseminate and research information regarding clinical procedures and delineations.
l. Inform and brief all department managers on new medical staff members.
m. Refer all new providers to the Physician Liaison for dynamic voice numbers and hospital tours.
n. Investigate all visiting providers within the facility.
o. Verify all provider information outside of the facility when patient is admitted to Mountain View Hospital for outpatient procedures.
p. Trend all occurrences that directly correlate with members of the medical staff.
q. Assist Chief Compliance Officer in data collection and presentation of all materials for Medical Executive Committee.
r. Distribute additional information to all medical staff members following Medical Executive Committee when deemed necessary.
s. Assist Chief Compliance Officer in overseeing all focused professional practice evaluations (FPPE) and peer review processes.
t. Create, transpose, and standardize all provider's orders and forms throughout the facility.
u. Ensures that Allied Health students and student doctors have completed the appropriate paperwork for their rotation.

2. Assist with other department functions, including Quality Assurance, Employee Health, Risk Management and Education.

3. Assist in typing, preparing and gathering information for reports or studies that are required by Committees or Administration.

4. Must be responsible, self-motivated and support a team atmosphere within the Compliance Department.

5. Must work well under pressure; meet multiple and sometimes competing deadlines.

6. Must be able to communicate effectively with all medical staff personnel.

7. Able to communicate verbally and answer phones with a pleasant demeanor at all times.

8. Must have the ability to effectively read and decipher handwritten documentation.

9. Demonstrate a clear understanding of the highly confidential nature of all facility and patient information. Demonstrates personal integrity in holding this information in the strictest confidence.

10. Demonstrates the ability to evaluate suggestions and criticisms objectively and wherever necessary undertakes to change behavior or seek further guidance.

11. Demonstrates self-motivation and personal responsibility for fulfilling tasks and assignments.

12. Utilizes educational resources of the facility and seeks educational experiences outside as well.

13. Maintains a responsible attitude toward appropriate and efficient management of the facility.
a. Always extends courtesy and a cooperative attitude while communication with colleagues, supervisors and all others.
b. Supports facility policy and assists in the process of policy change.
c. Demonstrates loyalty to the philosophy, policies, and practices of the hospital.

ABOUT MOUNTAIN VIEW:

Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley - all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.

Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.

Qualifications

Education/Certification: High School Diploma

Experience: Medical Clerical experience preferred. Must hold or work towards certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medial Services Management (CPMSM) or work towards obtaining certification.

Equipment/Technology: Excellent word processing skills, including Excel or other spread sheet experience.

Language/Communication: Requires language skills adequate for written and interpersonal communication in English. Must have a strong medical vocabulary.

Mental Capabilities: Work well under pressure

Performance: Be able to work well under pressure. Must be able to multi-task.

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