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Temporary Medical Credentialing Coordinator (Remote Option)

Company: Beacon Health System
Location: Elkhart
Posted on: November 24, 2022

Job Description:

Full-time



600 East Boulevard



Clerical



Day



20.73---26.96---33.18



Description



* This is a one year fixed term position with the ability to be totally remote or hybrid! Reports to the Manager of Medical Staff Services. This position handles file processing for provider appointment, reappointment and privileging, and analyzes and manages data verification. This is accomplished through the accurate and timely processing of credentialing or re-credentialing applications according to Bylaws, Rules & Regulations, Policies and affiliated accrediting bodies. This position works with and advises the medical staff office, department chairs, and administration to support and enhance the functions of the Medical Staff.



MISSION, VALUES and SERVICE GOALS



* MISSION: We deliver outstanding care, inspire health, and connect with heart.

* VALUES: Trust. Respect. Integrity. Compassion.

* SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.



Responsibilities



Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:



* Completes other job-related duties and projects as assigned.



Initial Credentialing and Reappointment:



* Obtains CV approval and submits an application to the practitioner within 48hours of receipt.

* Ensures privilege profiles are up-to-date after approval of initial appointment.

* Works with Managed Care, Central Verification Office (CVO), BMG Recruitment or others to obtain information on applicants.

* Perform file audits to ensure that all applications for initial appointment are complete and accurate.

* Maintains positive and proactive working relationships with others and provides timely and appropriate updates to credentialing status.

* Prepares individualized credential folders completely and in a timely manner for review by Department Chairmen and Credentials Committee.

* Ensure all associated regulations/standards are met.

* Prepares status reports of applicants to Credentials Committee, applicable hospital staff and Administration timely.

* Maintains current releases of information to satisfy hospitals' information requests or audits.

* Communicates practitioner appointments to hospital staff and administration.

* Answers the telephone promptly, professionally and pleasantly at all times.

* Maintains reappointment schedule for accurate and timely physician reappointment to the Medical Staff every two (2) years according to established guidelines and procedures.

* Distributes and processes reappointment information to the Medical Staff and their credentialing contact to ensure continuity of care.

* Inputs all reappointment information into credentialing database.

* Ensures privilege profiles are up-to-date after reappointment and accessible to stakeholders and hospital staff.



Credentialing Committee Coordination:



* Coordinates, prepares agenda (with Chairman) and attends Credentialing Committee meetings.

* Prepares and organizes all information going to Credentialing Committee.

* Follows up timely on all information/recommendations from Credentialing Committee to ensure timely progress of applicants and/or privilege changes.

* Responds to requests from practitioners, office managers, managed care organizations and Administration on the status of applicants in a timely and professional manner.

* Prepares timely agenda with Chairman, records minutes, and distributes information for Medical Staff meetings.

* Submit committee policies for review on a periodic basis.

* Maintains positive and proactive working relationships with Committee Chairmen and Members.

* Communicates action and directions from Medical Staff departments/committees to all appropriate areas.



Credentialing Administration and Database Maintenance:



* Maintains accurate and timely database information on practitioners on staff for optimal communication.

* Prepares and maintains key elements accurately on database so that information may be submitted for appropriate requests in a timely manner.

* Process and prepares membership and privilege change request through appropriate department and committees.

* Process and notifies appropriate departments regarding resignation notices.

* Maintains strict confidentiality of all credentialing information to protect the applicant, hospital and Beacon Health System from any potential liability.

* Maintains thorough knowledge of ISDH and other regulatory requirements having jurisdiction over credentialing and attends audits.

* Maintain and update privilege profiles to ensure accuracy on all databases.

* Recommends, builds, and provides periodic updates to privilege delineation forms and submits for authorization.

* Compiles, reports and responds to the annual Medicare Quality Improvement Organization for Physician Acknowledgement (CMS).

* Responds to requests for medical staff verifications from external hospitals and facilities in a timely manner.

* Scans necessary documents in appropriate credentialing file on the credentialing database in a timely manner.

* Provides roster of Medical Staff/AHP's as requested by hospital administration or medical staff officers in accordance with medical staff criteria.

* Reports issues regarding credentialing contracted services or credentialing software to Medical Staff Services Manager.

* Request application access for staff members through AMS.

* Meet and comply with regulatory body's audits and inquiries.



Qualifications



Education and Experience



* The knowledge, skills, and abilities as indicated below are normally acquired through the successful completion of a High School Diploma or Equivalent and specialized training as a Medical Staff Professional (MSP). Medical staff experience in credentialing, re-credentialing and Joint Commission standards is desired along with the CPCS certification.



Knowledge and Skills



* Ability with demonstrated competence in the Microsoft Suite of products.

* Written and oral communication is desired with emphasis on professionalism, grammar, medical terminology.

* Basic knowledge of Joint Commission Standards related to the organized medical staff.

* Respect for the importance of confidentiality.



Working Conditions



* Prolonged sitting and use of computers.

* Early and after hours meeting requirements.

* Travel to other locations within Beacon may be required.



Physical Demands



* Requires the physical ability and stamina to perform the essential functions of the position.

Keywords: Beacon Health System, Elkhart , Temporary Medical Credentialing Coordinator (Remote Option), Healthcare , Elkhart, Indiana

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