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Credentialing Coordinator

Manchester, NH

RSMC on behalf of our client 

We are currently in need of  Credentialing Coordinator
Pay rate:  $26.68/hr


Summary

Looking for someone to help with the credentialing functions.
We would like someone who is familiar with our credentialing software, ECHO, if possible, and this in an in-person, and not a remote, position.
  • Monday to Friday 8:30AM – 5:00PM

Roles & Responsibilities

POSITION SUMMARY:

Assists the Department Director, Medical Staff Support Services in all medical/administrative/legal processes required in and/or related to the granting and maintenance of medical staff membership and/or clinical privileges. Supports the purpose of the department in support of Catholic Medical Center’s overall mission and goals.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Under the direct supervision of the Department Director, Medical Staff Support Services, and within established Catholic Medical Center, departmental policies and procedures, Medical Staff Bylaws, Rules and Regulations, Credentialing Policy and other related manuals, the incumbent performs the following functions:
  1. Based on standard practice, responsible for coordinating, implementing and tracking initial credentialing and re-credentialing processes in accordance with departmental, organizational, medical staff and external policies and procedures. Keeps abreast of current requirements and any changes from regulatory agencies (Joint Commission, state laws and federal regulations) that impact these processes. Ability to apply this knowledge to credentialing practices.
  2. Based on standard practice, collects, reviews and prepares data for review by medical staff leadership on all requests for: change in membership category, modifications to clinical privileges, leaves of absences, temporary privileges, resignations, expedited applications, and proctoring.
  3. Maintains accuracy of credentialing components of medical staff database (ECHO) system and hospital (SMS) information system, and related upgrades, in accordance with departmental policies and procedures. Adheres to departmental, organizational and Information System confidentiality standards.
  4. Responsible for coordinating, implementing, tracking and analyzing the application and verification process for all initial appointments and reappointments to the medical staff by obtaining primary source verification from: medical schools, training programs, employment affiliations, health care institutions, peer references, malpractice companies, licensing agencies, certification organizations, government agencies and peer review data from internal departments. Ensures all applications and reapplications for medical staff privileges are comprehensive and complete for review and signature by the section chief and department chair prior to presentation at the Credentials Committee meeting, Medical Executive Committee and Board of Directors.
  5. Participates in all process improvement initiatives for appointment and reappointment processes. This includes but is not limited to review of policies, procedures, forms and other information related to the credentialing process. Coordinates data collection and distribution with the Process Improvement Department.
  6. Immediately informs Director of any adverse, questionable and/or negative information received on any initial appointments, reappointments, or other related functions. Assures follow-up to all negative responses prior to review and recommendation by the section chief.
  7. Assists Credentials Committee Chairman in supporting the Credentials Committee. Tasks include: agenda preparation, synopsis preparation, meeting notices and minutes. Ensures timely follow-up on any action items or correspondence discussed at the credentials meeting.
  8. Provides administrative support and gathering of information to medical staff leadership, departments and sections. Assists in the administrative development and preparation of criteria for clinical privileges and any revisions to delineations of clinical privileges.
  9. Provides support to Medical Staff leadership for the completion of Focused Professional Practice Evaluation s (FPPE) and Ongoing Professional Practice Evaluation (OPPE) in accordance with Joint Commission requirements and Medical Staff Policy.
  10. Ability to communicate clearly to inform and update members of the medical staff on relevant issues. Responsible for providing critical analysis of systems applications and exhibiting attention to detail of information received, in all medical staff credentialing functions ensuring compliance with the Medical Staff Bylaws, Rules and Regulations, and Joint Commission standards
  11. Responds with accuracy and maintains confidentiality to requests for Medical staff information from outside agencies, hospital departments and the public.
  12. Supports Medical Staff meetings to include: assisting chairman in the development and distribution of agenda, records and distributes minutes, completes follow up activities, and maintains schedule of meetings.
  13. Generates and modifies as needed, on a monthly basis, correspondence to members of the Medical Staff on behalf of the Board of Directors.
  14. Ongoing professional and educational development internally and externally is expected to maintain current knowledge of field
  15. Assists Director with special projects and other duties as needed.
  16. Participates as a team member with staff for telephone coverage, assistance with workload and involvement in staff meetings.
  17.  Exercises care in the operation and use of equipment and reference materials. Performs routine cleaning and preventative maintenance to ensure continuing functioning of equipment. Maintain work area in a clean and organized manner.
  18. Assists in various office duties such as filing, copying, etc.

Preferred Qualifications

Minimum Qualifications

Education:
  • Associates degree preferred.
Experience:
  • 5 years of office support experience in a high-volume fast paced office setting, preferably in a health care environment.
  • Excellent computer skills with ability to operate standard software in a Windows environment.
  • Excellent organizational and communication skills and ability to work without supervision.

Licensure/Certification:

  • Certified Provider Credentialing Specialist (CPCS) preferred.

KNOWLEDGE, SKILLS AND ABILITIES

  • Individuals must possess the following knowledge, skills and abilities or be able to explain and demonstrate that the individual can perform the essential functions of the job, with or without reasonable accommodation, using some other combination of skills and abilities and to possess the necessary physical requirements, with or without the aid of mechanical devices to safely perform the essential functions of the job.

 Role Specific Skills:

  1. Ability to work independently as well as in a team and handle multiple priorities at one time.
  2. Ability to plan and perform a wide variety of duties requiring knowledge of appropriates policies and procedures. Requires considerable judgment to work independently toward general results, devising methods, modifying or adapting standard procedures to meet different conditions, making decisions based on precedent and policy.
  3. Ability to demonstrate critical thinking and analysis in all responsibilities.
  4. Ability to receive training and guidelines from supervisor on non-routine duties.

Required Skills

Work Authorization

  •  US Citizen
  •  Green Card

Certifications & Clearance Requirements

             Not Required

Benefits

  •  Dental
  •  Eye Care
  •  Medical
www.rsmcservices.com 

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