Credentialing Coordinator

Overview

Saint Joseph Hospital is a 433-bed facility located in Lexington Kentucky. Founded in 1877 a small group of Sisters of Charity of Nazareth in Kentucky led by Sister Euphrasia Stafford began their health ministry. Their mission was to provide compassionate care to the poor and underserved – a tradition still carried out today. Saint Joseph Hospital primarily serves central and eastern Kentucky with a full range of services including distinguished awards for cardiology orthopedics and stroke care. CHI Saint Joseph Health supports 5000 active employees 8 hospitals specialty clinics and a Medical Group with more than 200 locations across Central and Eastern KY. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

JOB SUMMARY / PURPOSE

Supports and maintains the medical staff governance in their function of credentialing and privileging, including but not
limited to processing Medical Staff, Licensed Independent Practitioners and Advance Practice applications for
appointment and reappointment to ensure practitioners are trained, educated, and competent for all hospital service
agreements. Ensures credentialing and processes are in compliance with the professional standards, medical staff
bylaws, state and federal regulatory standards.

 

ESSENTIAL KEY JOB RESPONSIBILITIES

ESSENTIAL FUNCTIONS:

1. CREDENTIALING (weight 20%)
(Hot Springs Providers – approximately 425 providers)
Credentials medical staff applications and reappointment applications.
Follows up on needed information for physician credentialing files.
Physician files are kept up to date with current information filed correctly.
Stays abreast of new Joint Commission and Arkansas Department of Health standards regarding credentialing of physicians.
Provides up to date physician privilege forms for all hospital departments.
Orders and retrieves credentialing reports from the State Medical Boards.
Provides application packets to potential medical staff members.

Processes requests for temporary privileges, increase in privileges and locum tenens privileges. Researches privilege criteria
and drafts privilege lists as needed.
Exhibits the ability to make effective decisions based on verifiable and measurable data/criteria
Maintains Medical Staff, Licensed Independent Practitioners and Advanced Practice privilege lists including but not limited
to posting changes and privileges granted by the Board of Directors, Medical Executive Committee and/or Quality & Value
Committee.
Processes medical staff affiliation requests from other hospitals, health plans and state agencies.
Monitors and maintains the database for all Medical Staff, Licensed Independent Practitioners and Advanced Practice
licensure, insurance and required certifications for compliance with Medical Staff privileges, sending notices and posting
current documentation as necessary.
Responsible for build, maintenance, and functionality of current database (Symplr). Train Medical Affairs staff on utilization
of database.
Supports Chief Medical Officer and Medical Staff members in tracking proctoring requirements and composes letters and
reports for follow up.
Ensures credentialing and processes are in compliance with professional standards, medical staff bylaws, state and federal
regulatory standards and The Joint Commission.
Conducts audits of credentialing and privileging documents and files.
Trains credentialing administrative assistant to meet the needs of the medical affairs department
IRS reporting for medical staff annually
Annual review of all medical staff policies and protocols, bylaws and revisions
Annual Kepro audits
Reporting influenza vaccination data for physicians
 Serve as the Joint Commission and State Health liaison for credentialing files and matters of the Medical Affairs
Department.
Supports and maintains the medical staff governance in their function of credentialing and privileging, including but not
limited to processing Medical Staff, Licensed Independent Practitioners and Advance Practice applications for
appointment and reappointment to ensure practitioners are trained, educated, and competent for all hospital service
agreements. Ensures credentialing and processes are in compliance with the professional standards, medical staff
bylaws, state and federal regulatory standards.
2. COMMUNICATION (weight 20%)
Keeps track of physicians under observation status
Gathers information for Credentials Committee in order for the Committee to make decisions on physician
appointment/reappointment applications.
Communicates professionally with physicians, office managers and others with internal and external customers/providers.
Always identifies self when answering phone and accurately analyzes nature and urgency of caller directing to the
appropriate person
Gives and receives feedback to others.
Updates necessary hospital departments regarding newly credentialed physicians.
Collaborates with immediate supervisor to establish, define, and refine department goals and objectives consistent with the
facility’s Mission and Values, and demonstrates satisfactory progress towards these goals and objectives.
Facilitates open and timely communication between the Medical Staff, the hospital and key personnel for those we have
current contracts with for credentialing, privileging and medical school affiliates.
Updates Medical Staff Rosters as changes occur. Assists Marketing with the annual Medical Staff Directory updates and any
needs of promoting new physician to our community.

Provides primary assistance to callers and visitors of the Medical Staff Office.
Facilitates/coordinates all communications that directly/indirectly affect the functioning of the medical staff, making certain
that said communications are delivered, with response and follow up given in a timely manner.
3. MEETINGS (weight 30%)
Provides required information to the Medical Staff Committees in order to review applications and reappointment
information
Prepares all necessary document for All Physician led Committee Meetings
Prepares and composes all correspondence
Assists with providing required information to the Medical Staff Committees in order to review FPPE/OPPE data for
competency
Provides administrative support assistance in all medical staff related meetings including but not limited to scheduling,
sending notices, preparing agendas and meeting packets, recording and distributing meeting minutes as required.
Prepares Board Reports and Board Appointment Letters for the CEO and Medical Staff Appointments.
Attends designated meetings, and provides support functions as required, such as, following up on all tasks, letters, and
other items as indicated.
Responsible to make certain all medical staff departments and committees are operating within criteria and intent of the
medical staff bylaws, medical staff policies and procedures.
4. CONFIDENTIALITY (Weight 10%)
Has a good understanding and adheres to departmental/hospital policies regarding confidential information. If unsure of
something, refers question to Chief Medical Officer.
Knows individuals who have been authorized for access to confidential physician information, does not discuss confidential
information outside of department.
Secures confidential information when away from desk. Does not leave information accessible for visitors to see.
Has access to restricted or confidential patient and physician information and must comply with the terms of the Hospital
Security Policies as it applies to job role.
5. PHYSICIAN SERVICES (Weight 20%)
The Medical Affairs department acts on the physician’s behalf when there is any need of our Medical Staff.
Initiate and process requests for computer access and training for employed and non-employed physicians
Supervises and coordinates orientation and computer training for all providers
Coordinate physician first day orientation with Chief Medical Officer
Facilitates tours of the facility for all new physicians
Compiles physician orientation notebooks
Assists physicians with any access request, IT issues, supply needs
Supports the medical staff in complaint resolution by gathering supporting information to take before the Chief Medical
Officer
Ordering items they may need, finding services they may require, taking any complaints and gathering supporting
information to take before the Chief Medical Officer.
Supporting our medical staff in any instance where they may become frustrated. Taking on the job to alleviate any of that
from their day to day and allowing them to focus on patient care.
OTHER
 Demonstrates initiative and problem solving skill using sound judgment.
 Assumes additional responsibilities as needed with little or no direction; shows initiative in assisting others
within the hospital and administrative departments.
 Maintains established departmental policies and procedures, objectives, quality assurance, and safety
standards.
 Seeks to accomplish the integration and collaboration of all medical staff functions when necessary throughout
the hospital.
 Coordinates all planning for offsite physician meetings as well as hosting these events.
 Prepares correspondence, reports, memoranda, and special projects for Chief Medical Officer, Medical Staff,
Hospital Administration, and other departments as requested.
 Coordinates requirements and needs of medical staff visitors, students and shadows.
 Supervise and coordinate orientation and computer training for all Integrated and Non Integrated Providers.
 Trains and supervises and contract services and or volunteers to meet the needs of the Medical Affairs
Department.
 Compiles and Coordinates physician first day Orientation with Chief Medical Officer, process request for
computer access and facilitates all tours of the facility for new physicians both Integrated and Non Integrated.
Compiles Physician Orientation Notebooks.
 Initiate and process request for computer access and training for non-employed physicians.
 Serve as a hospital representative on the Board of the Arkansas Association of Medical Staff Services

Qualifications

Required Education and Experience:

 

High School diploma

Minimum of one (1) year of experience in medical staff
services, hospital administrative department or credentialing
verification organization. Comparable healthcare or managed
care work experience may be considered.

 

Required Licensure and Certifications: None

 

Required Minimum Knowledge, Skills, Abilities
and Training:

 

Good communication skills, both oral and written are essential.
Computer literacy and excellent typing skills are essential. Must
possess good organizational/analytical skills, able to make
judgments. Must possess willingness to learn medical
terminology.

Pay Range
$18.74 - $25.77 /hour