Address
Form of workThe Plastic Surgery Department is looking to hire a full time Medical and Credentialing Staff Coordinator. The Coordinator will be in charge of managing staff and faculty Credentialing and licensing. The candidate will need to have previous credentialing experience, and would ideally have a CPCS or CPMSM certification, or be willing to be certified in 2-3 years of joining the department
Experience and EducationHigh school diploma or equivalent & knowledge of anatomy, physiology, medical terminology & The Joint Commission (TJC) standards are required.
Two (2) years experience in the field of Medical Staff credentialing, or completion of a specialized training program in the field of Medical Staff credentialing (i.e. Associates Degree in Credentialing) is required. Certification by the National Association of Medical Staff Services at time of employment in CPCS or CPMSM is preferred.
Manages the distribution and receipt of credentialing & privileging applications, peer review forms and continuous updating of Departments' privilege form to reflect current privileges & corresponding privileging criteria.
Serves as a professional resource for Departments' Credentialing Contacts, Physicians/Practitioners, Credentials and Medical Executive Committees and the Health System Board regarding the credentialing & privileging process including new applications, any privilege form or criteria changes, & reporting status with the processing of all files.
Solely responsible for reviewing the content of the completed evaluation forms which includes verification of applicants' education, training, board certification, licensure, other certifications and past work history. Identifies any discrepancy, erroneous information and/or issues of impairment (health, drug, alcohol, etc.) from the application based on the results of the primary source verification.
After seeking clarification, responsible for reporting findings to Credentials Committee. Reports to the Department Chair/Designee any instances where the privileging criteria are not met.
Verifies status with Federal & State sanctions. Reports any sanctions found to manager, director and Chief Medical Officer.
Issues all letters associated with the appointment & any necessary requests for computer access, FNEA numbers for the physicians, upon notification of approval by the Health System Board. Responsible for meeting required performance metric relating to the timely processing of applications and managing individual workload to prevent late reappointments, or delayed initial appointments.
Maintains & validates the accuracy of the physician profiles in the hospitals' and Managed Care Organizations credentialing data- base system to accurately reflect status, findings of credentialing process, and hospitals' financial and coding systems. Generates varies reports and completes special projects as assigned and in a timely manner.
Performs other duties as assigned.
**Other Duties: Performs other duties as assigned.
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