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The Medical Staff Credentialing Coordinator promotes standards and healthcare practices that are in compliance with the rules and regulations as they are set by the states in which the company operates. The Coordinator, Medical Staff Credentialing supports the efforts of the Company to develop and implement streamlined processes within the Medical Staff Office related to policy and procedure development, monitoring and completion of all initial appointments, reappointments and expirables, The Medical Staff Credentialing Coordinator is responsible for ensuring that all Medical Staff appointment and reappointments are timely and complete.

Job Duties and Responsibilities

Essential Functions

  1. Monitors the initial, reappointment and expirables process for all Medical Staff, Allied Health Professional staff ensuring compliance with regulatory bodies, as well as Medical Staff Bylaws, Rules and Regulations, policies and procedures, and delegated contracts.
  2. Ensure the organization maintains regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations.
  3. Leads, coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
  4. Ensures that all Medical Staff applicants go thorough background investigation, research and primary source verification of all components of the file.
  5. Performs queries; submits and retrieves National Practitioner Databank reports in accordance with Health Care Quality Improvement Act.
  6. Identifies any issues that may require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
  7. Prepares credentials file for completion and presentation to the Medial Staff Committees, ensuring file completion within time periods specified.
  8. Ensures that the facilities processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.
  9. Responds to inquiries from other healthcare organizations regarding credentialing and privileging issues as they arise.
  10. Participates in the development of Company policies and procedures including credentialing and privileging documents
  11. Provides education to the organization and training to the facility credentialing personnel related to the Medical Staff policies and procedures and credentialing/privileging functions.
  12. Serves a resource for the organization as it relates to Medical Staff policies and processes.
  13.  Completes other assigned duties under the direction of the Director, Health Information Management.

Qualifications

Educational/Experience Requirements

  • Associate’s degree or equivalent experience preferred.  Experience in hospital medical staff credentialing required.
  • Certified with National Association of Medical Staff Services preferred.

Qualifications/Skills

  • Demonstrates strong computer skills to navigate MS office products and electronic compliance software solutions.
  • Knowledge and understanding of CMS, The Joint Commission and State Department of Health and Hospitals regulations regarding Medical Staff.
  • Good written and oral communication skills.
  • Demonstrates personal traits of a high level of integrity, team orientation, professionalism, and trustworthiness. Places a high value on ethical standards and treating others with dignity and respect.
  • Must successfully complete CPR certification and an Oceans approved behavioral health de-escalation program.

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Type: Full Time (Hourly)
Job ID: 24984