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UH
University Hospitals Careers
Med Staff & Credentialing Coordinator (Hybrid)
Career Insights for Registrar / Patient Service Representative
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What they do
A Registrar or Patient Service Representative provides direct assistance to patients at a health care or long term care facility. Answers questions and helps resolve complaints; provides liaison with health care providers; may assist with coordinating appointments or addressing billing or insurance issues.
$43,797 / year median in Ohio
+7% projected growth
Job Description
A Brief Overview The Medical Staff Services and Credentialing Coordinator is responsible for oversight of the credentialing process and analyzing and evaluating primary source verification data and documents for initial appointments and reappointments. This position provides support for facility and/or specialty assignments throughout the health system. Under the supervision of the Manager of Medical Staff Services and Credentialing and in addition to the duties outlined below, this position functions as an agent of the protected peer review process. This position is responsible to maintain and develop hospital leadership relationships. What You Will Do Analyzes and completes the initial and reappointment application approval process by utilizing independent critical thinking skills, which may involve extensive investigative review and interpretation Partners with Medical Staff Leaders to develop policies, evaluation standards and privilege forms based on regulatory changes or hospital service changes serves as the liaison with Board Members, UH Senior Leaders and Administrators Leads and manages provider performance evaluation process in accordance with Regulatory standards and Medical Staff Bylaws to assess clinical competency at initial approval and annually thereafter to monitor trends Participates in all aspects of meeting management, to provide support for Credentials Committee, Medical Executive Committee/Clinical Council, Quality & Professional Affairs Committee, Hospital Board, and all other applicable medical staff meetings Monitors and follows up on the proctoring process for privileges to ensure timely completion and documentation in accordance with credentialing requirements and regulatory standards for quality purposes Manages the Medical Staff elections process, from ballot distribution through certification of results, ensuring adherence to bylaws and communication with Medical Staff leadership Leads and manages provider performance evaluation process in accordance with The Joint Commission (TJC), Det Norske Veritas (DNV), Centers for Medicare and Medicaid (CMS) and the Medical Staff Bylaws Manages the Medical Staff Dues process, including preparing and distributing annual invoices, tracking payments, and maintaining accurate financial records in accordance with Medical Staff Bylaws Collaborates with leadership to update and create new operational procedures as needed to align with industry standard Serves as content expert and participates in onboarding and training of new team members and supports the medical staff with credentialing related projects as aligned with skill set Investigates issues that arise with providers and may involve physicians, UH staff, and/or hospital leadership Manages data quality and integrity for web-based applications based on defined standards through systematic audits. Additional Responsibilities Performs other duties as assigned. Complies with all policies and standards. For specific duties and responsibilities, refer to documentation provided by the department during orientation. Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace. Education Bachelor's Degree (Required) or Three (3) years of direct credentialing experience accepted in lieu of Bachelor's Degree. Master's Degree (Preferred) Work Experience 3+ years of experience working in a similar role, preferably in a healthcare setting (Required) and 2+ years of experience with database utilization and data management (Required) Knowledge, Skills, & Abilities Strong analytical and quantitative skills (Required proficiency) Advanced verbal, writing and editorial skills (Required proficiency) Attentive listening skills (Required proficiency) Confidence interacting with UH Senior Leaders, Physicians, Board Members, and outside agencies (Required proficiency) Critical thinking skills, which result in making independent procedural decisions and judgments (Required proficiency) Skill in establishing priorities with independent coordination of day-to-day activities (Required proficiency) Demonstrated knowledge of medical terminology (Required proficiency) Excellent communication and organizational skills (Required proficiency) Ability to work in a fast-paced environment (Required proficiency) Ability to multi-task (Required proficiency) Excellent computer skills, including knowledge of Microsoft applications (primarily Excel) knowledge of Adobe Acrobat Professional and credentialing database experience (Required proficiency) Exercises strong attention to detail to ensure compliance with bylaws, policies, and regulatory standards (Required proficiency) Licenses and Certifications NAMSS CPCS and/or CPMSM certification ( within 5 Years) Physical Demands Standing Occasionally Walking Occasionally Sitting Constantly Lifting Rarely up to 20 lbs Carrying Rarely up to 20 lbs Pushing Rarely up to 20 lbs Pulling Rarely up to 20 lbs Climbing Rarely up to 20 lbs Balancing Rarely Stooping Rarely Kneeling Rarely Crouching Rarely Crawling Rarely Reaching Rarely Handling Occasionally Grasping Occasionally Feeling Rarely Talking Constantly Hearing Constantly Repetitive Motions Frequently Eye/Hand/Foot Coordination Frequently Travel Requirements 10%