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Credentialing Specialist

1 month ago

Cincinnati, United States NavitsPartners Full time
Title: Credentialing Specialist
Location: Norwood, OH 45212
Duration: 13 Weeks
Shift: M-F 8AM-4:40PM
Hours: 32-40 hours per week
Preferred: CPCS certified
Attire: Business Casual
Shift Schedule: Day

Required: 5 years experience in Physician Credentialing and privileging. Strong Excel experience.

Job Summary:
  • Responsible for coordination and preparation of medical staff functions; prepares for committee meetings, taking minutes, processes and distributes appropriate correspondence and assists with the development, planning and implementation of the credentialing and privileging process in addition to the analysis of each file upon completion.
  • Assists in the compliance with the accrediting and regulatory agencies (i.e., Joint Commission and NCQA) in regards to credentialing and privileges while developing and maintaining a working knowledge of the statues and laws.
  • Ensures that all expirable are reviewed, obtained and managed on a monthly basis according to the rules and policies.
  • Maintains the confidentiality of all business/work and medical staff information.
  • Assists in the managing the flow of information between medical staff services, Credentials Committee and MEC Committee, medical staff leadership and Chief Medical Officer.
  • Manages the FPPE process and the integration of OPPE during reappointment.
Job Responsibilities:
  • Coordinate the credentialing activities of the Medical Staff and Allied Health Staff, in accordance with the Medical Staff Bylaws, Credentialing Policies and Procedures of client as well as the federal and state law, regulatory and accrediting agencies.
  • Provide administrative support to Credentials, General Staff and other Medical Staff committees and departments of client as directed.
  • Process requests for temporary privileges and monitor all follow-up, in accordance with policies and procedures.
  • Process requests for additional privileges and monitor all follow-up, in accordance with policies and procedures.
  • Process requests for one-time privileges, visiting physicians and/or student observers.
  • Coordinate verification of professional liability coverage, medical licensure, board certification, BLS, ACLS, ATLS, and/or NRP certifications and DEA certification, as required.
  • Obtain updated PPD and annual AHP evaluations.
  • Assist with the coordination of annual dues process.
  • Credentialing/Database management.
  • Assist customers in the absence of the Credentialing Assistant and/or Administrative Assistant.
  • Assist with Joint Commission accreditation preparation, as necessary.
  • Assist with coordination of yearly on-call schedule preparation and coordination of Department Director election (every two years).
  • Coordinate preparation and distribution of new committee roster (every two years) and yearly master calendar.
  • Assist with verifications of medical staff membership and clinical privileges of providers from other healthcare facilities.
  • Assist in coordination of medical staff events and functions and other duties assigned.
Required Skills & Experience:
  • Minimum of three years in a healthcare setting performing credentialing, privileging, and medical staff services functions.
  • Applicant must have a good verbal, written and telephone communication skills.
  • Must be able to multi-task, attention to detail and strong interpersonal skills are required.
  • Must be able to work independently and exercise independent judgment regarding the credentialing and privileging of providers as well as other medical staff services' decisions and have the ability to define problems, prioritize issues and develop and implement solutions.
  • This individual must be a self-starter who functions well in a team providing leadership example by demonstrating exceptional standards in issues such as team work and interpersonal relationship development, reliability and attendance, professional appearance, and commitment to and participating in quality improvement programs.
  • Must have strong computer experience with database management, Microsoft Office and Windows applications.
  • Must have experience with Joint Commission and other healthcare regulatory bodies.

Physical Requirements: Climbing, stooping, kneeling, reaching, standing, walking, pushing, pulling, lifting, carrying.

Required Education: High School Diploma or equivalent.

Preferred Education: Associates Degree or equivalent combination of education and related experience.

Preferred Certifications & Licensure: CPCS or CPMSM