CREDENTIALS COORDINATOR

JOB DESCRIPTION DETAILS

Job Summary :

Provides support for all credentialing functions and meeting coordination within the Medical Staff Services Department. Processes new applications and reapplications for the Medical Staff. Responsible for verifying proper training, credentials, insurance, certifications, licensure and keeps accurate database records. Monitors license and credentials expiration dates and advise staff members of required "renew by" dates. Performs background checks and verifies eligibility through competency documentation, before assigning privileges. Gathers quality & volume data for the reappointment cycle through database abstraction and reaching out to other entities. Ensures that state, federal, and other regulations are met pertaining to credentialing requirements for Physicians, Podiatrists, Dentists, Telemedicine Providers and Advanced Practice Providers. Coordinates credentials file review with department chairs & credentials committee members. Creates the agenda and assembles the credentials committee meeting packets. Provides meeting support and takes minutes. Conducts research on updated state and federal regulations and policies. Releases information to requesting agencies and public inquiries when required by law. Help develop internal credentialing processes. Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institution.

Education :

Position requires a High School Diploma. Associates degree preferred.

Registration/Certification/Licensure :

Certification required: CPMSM (Certified Professional in Medical Services Management), CPCS (Certified Provider Credentialing Specialist), or CPHQ (Certified Professional in Healthcare Quality). If not currently certified, will consider 3 years of credentials experience and must agree to complete certification within 1 year of eligibility to take exam.

Experience :

Position requires a combination of 3 years of related experience. Credentialing experience working in a healthcare setting or payor enrollment setting is preferred.

Other Requirements :

Maintains unit-specific and hospital competencies, mandatory learning, and any clinical certifications required in accordance with the Staff Education and Training policy GA-057 and/or any other department requirements. Experience with database programs desired. Ability to communicate effectively verbally and in writing. Ability to handle multiple tasks, work with interruptions and reprioritize often. Good interpersonal skills are necessary due to diverse customer group. Must be attentive to details. Knowledge of medical terminology is required.

Location:

Calvert Health System •

CMC MEDICAL STAFF

Schedule:

Full Time, Day Shift, 8 am - 4 pm