medical staff credentialing coordinator - P C BEACH, FL , USA, United States - Universal Health Services

Description

Responsibilities

Medical Staff Credentialing Coordinator Opportunity

Emerald Coast Behavioral Hospital provides inpatient treatment services to children, adolescents and adults at our 86-bed facility in Panama City, FL and outpatient services to adolescents and adults at our three outpatient centers located throughout the Florida Panhandle.

Additionally, we offer specialized treatment for active duty military members through our Military Resiliency Program, specialized chemical dependency treatment and TMS therapy for chronic depression.

Visit us online at:

The Medical Staff Credentialing Coordinator serves as an essential link and resource between management and Medical Staff to coordinate the operational processes and ongoing credentialing, privileging, and Medical Staff governance functions.

Responsible for review, analysis and follow up of credentialing and privileging applications, maintaining strict confidentially and ensuring compliance with Medical Staff and Hospital policies and accrediting and regulatory agencies.

Job Duties/Responsibilities:
Departmental Operations

• Organizes and maintains credentialing files and prepares credentialing packets for potential applicants and re-appointments.
• Maintains and updates credentialing database continuously and consistently assuring accuracy and completeness.
• Assists with orientation and on-boarding for all new providers including medical and nurse practitioner students.
• Maintains accurate records on malpractice insurance for all providers and licensed therapists. Processes malpractice applications for employed staff.
• Maintains provider enrollment for billing purposes on all providers and licensed therapists. Processes Medicare applications.
• Establishes and maintains nursing protocols between nurse practitioners and physicians.
• Establishes and maintains effective communication with providers, management, staff, students and outside agencies fostering a positive relationship.
• Conducts reports as requested. Assists with expense reports for Medical Staff.
• Attends and participates in all team related meetings.
• Acts as back up to Medical Staff Services Director as needed.

Credentialing and Privileging

• Conducts, participates in, and maintains credentialing and privileging. Includes initial appointments and re-appointment applications.
• Works with applicants and potential applicants to assure applications are completed/submitted on a timely basis. Performs detailed and thorough review of applications, primary source verifications and sources provided. Screens application and supporting documents for completeness. Identifies discrepancies and conducts follow-ups.
• Processes requests for privileges.
• Serves as a main point of contact for providers during application process, providing timely updates and additional information as requested.
• Compiles, evaluates, and presents providers' specific data collected for review by decision-making bodies.

Primary Source Verification

• Conducts, participates in, and maintains primary source verifications such as: Competence, medical/professional education, relevant training (internships, residency, fellowship, additional formal training), relevant board certifications, hospital affiliations/work history/military experiences, peer references, professional licensure, DEA, malpractice (history), privileges, querying National Practitioner Data Bank (NPDB) as appropriate, querying American Medical Association (AMA), OIG, etc.

OPPE/FPPE

• Organize information and data to identify / explain trends, problems and their causes. Analyzes and prepares presentations and reports regarding provider performance improvement and ensures quality/competence data is clear, concise and structured. Communicates concerns and findings to Medical Staff Services Director and Medical Director.
• Participates in OPPE/FPPE Review process.

Accreditation and Regulatory Standards

• Maintains a working knowledge and participates in an ongoing assessment of governing documents (bylaws, rules and regulations/policies and procedures) to ensure continuous compliance.
• Participates in surveys and audits of regulatory and accreditation agencies or organizations. Demonstrates an understanding of state and regulatory standards.

Medical Staff Functions

• Facilitates meetings such as Medical Executive Committee (MEC), Governing Board and Medical Staff Meetings. Includes committee notification reminders, agendas, taking minutes and sending out correspondence to committee members.
• Conducts and executes special projects as required.

Benefit Highlights:

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries
• More information is available on our

Benefits Guest Website:
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance.

During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S.

states, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications


Requirements:

• High School Diploma or Equivalent Required. Some college or post high school education preferred.
• Certified Provider Credentialing Specialist (CPCS) OR Certified Professional in Medical Services Management (CPMSM) within four (4) years of employment.
• Five (5) years administrative office experience, preferably in a medical/hospital environment required. Three (3) years credentialing experience preferred.
• Proficiency in Microsoft Office programs. Ability to apply technical and computer / software skills. Excellent communication, interpersonal, organizational, and service excellence skills. Must be detail oriented and able to multi-task and change direction quickly. Presents oneself in a positive and professional manner through appearance and conduct.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates.

UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries.

During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email.

Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement.

We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.