CREDENTIALING SPECIALIST - MEDICAL STAFF

• Hospital-Main Campus
• Business Support
• Full-Time
• Monday-Friday 8AM-4:30PM
• MEDICAL STAFF
• 8557

Job Description

Benefits

In addition to competitive compensation and wellness benefits (medical, dental, vision and prescription) Beebe Healthcare also offers:

• Sign-on and Referral Bonuses for select positions
• Tuition Assistance up to $5,000
• Paid Time Off
• Long Term Sick accrual
• Employer Contribution Plan
• Free Short and Long-Term Disability for Full Time employees
• Zero copay for drugs on prescription plan for certain conditions
• College Bound 529 Savings Plan
• Life Insurance
• Beebe Perks via Work Advantage
• Employee Assistance Program
• Pet Insurance

Overview

Under the direction of the Manager of the MSSD, the Credentialing Specialist (CS) manages the functions required to support credentialing and privileging activities of the medical staff organization. Ensures that the credentialing and privileging activities of the medical staff organization meets all internal requirements (bylaws, rules and regulations, policies and procedures) while ensuring compliance with external accreditation (The Joint Commission standards, state laws and Medicare Conditions of Participation). This includes, but is not limited to application management, primary source verification of credentials, file maintenance (electronic and/or hard copy), and maintenance of expiring information, information management and direct support of the evaluation and decision-making process.

Responsibilities

• Collaborate closely with the Manager of MSSD, department chairs, and the Credentials Committee to define privilege forms and establish criteria for granting privileges.
• Coordinate application management to ensure a timely credentialing and re-credentialing process in compliance with Medical Staff bylaws.
• Oversee data entry for primary source verification and practitioner credentials, adhering to procedures outlined in the Medical Staff bylaws, Rules & Regulations, and policies.
• Prepare practitioner information for review and evaluation by medical staff leaders, supporting follow-up actions related to practitioner qualification and competency management.
• Identify and flag potentially adverse information for review by medical staff leadership.
• Monitor practitioners for compliance with privileging or membership criteria, including tracking expiration dates for DEA, licenses, professional liability insurance, and board certifications.
• Maintain and update credential files and the practitioner database.
• Support the Medical Staff Quality Coordinator in competency management functions, such as proctoring and performance evaluations, in accordance with bylaws and policies.
• Communicate ongoing status and issues related to assigned work to the Manager of MSSD.
• Develop and maintain tracking mechanisms for physician-related information, including medical record fines and other relevant data, and share updates with necessary medical staff personnel.
• Initiate and run computer programs to obtain essential physician statistics and credentialing data.
• Attend physician functions and ensure appropriate office/phone coverage during absences.
• Manage multiple duties and assignments simultaneously, meeting designated deadlines.
• Organize meeting management for medical staff departments or committees, including scheduling, agenda planning, in-meeting support, and post-meeting documentation and follow-up.
• Ensure all documentation reflects the activities undertaken by individuals and meeting members, communicating relevant information to the MEC, board of directors, and other stakeholders as needed.
• Maintain minutes for all medical staff committee and department meetings for archiving and regulatory compliance.
• Facilitate communication between the medical staff organization and administration on matters requiring collaboration.
• Assist the Manager of MSSD in maintaining the confidentiality of medical staff credential files and quality files.
• Support the maintenance, review, and creation of medical staff office policies and procedures in conjunction with the Manager of MSSD.

Qualifications

• Recommended two years of experience in credentialing and privileging.
• Familiarity with medical and legal terminology is preferred.
• Proficiency in Microsoft Office products and credentialing software, with the ability to learn new database programs.
• Excellent interpersonal communication skills are essential.
• Ability to work effectively in a highly confidential environment.
• Strong computer skills are necessary.
• Knowledge of additional business subjects is desirable.
• Certification is strongly encouraged once eligibility requirements for the exam are met, though it is not required.

Competencies Skills

Essential:
* Clear Communication Skills Both Written and Verbal
* Knowledge Of Basic Computer Programs
* Able To Keep Confidential Information Regarding Patients, Team Members
* Able To Withstand Crisis Situations
* Has Skills to Provides Customer Service to Patients, Team Members and Visitors
* Experience With Excel, Power Point, Word, Visio, Etc.

Credentials

Education

Essential:
* High school graduate or equivalent

Entry

USD $24.14/Hr.

Expert

USD $37.42/Hr.

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