Credentialing Specialist

Job Description: Credentialing Specialist

• 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 expiries 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 the company 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 TCH 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.

Requirements:

• Must have 5+ years of experience from a hospital/health system credentialing physicians and/or advanced practice staff.
• Must be strong in Excel and have great attention to detail.
• Understanding of what needs to be verified, Joint Commission accreditation rules, privileging, license verification, board certifications, anything the provider is licensed to do.
• Please avoid submitting any candidates who only have credentialed nurses, allied staff or non-physician/advanced practice staff.
• Preferred: Cactus/Symplr experience is strongly preferred
• Required: 5 years experience in Physician Credentialing and privileging.
• Preferred: CPCS certified

Schedule Notes:13 weeks M-F 8AM-4:40PM Hours: 32-40 hours per week
Attire: Business Casual

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Equiliem Healthcare specializes in staffing clinical, non-clinical, and allied personnel. We excel in all levels, disciplines, and specialties within the healthcare spectrum. Our projects range from short to long term local and travel assignments. Equiliem has been recognized as a certified small business enterprise. In addition, we are proud that we have earned the prestigious Joint Commission accreditation for staffing firms and have been awarded Best in Staffing 4 years running by our employees and client partners.
 
Benefits offered to our workers include the following:

• Medical Insurance
• Vision & Dental insurance
• Life Insurance
• 401K
• Commuter Benefits
• Employee Discounts & Rewards
• Payroll Payment Options