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- Obtains verifications from authorized sources in conformance with established procedures. Follows standard operating procedures to ensure that the proper process has been followed when obtaining a verification. Responds to practitioner issues and concerns and advises Credentials Analyst of alternatives in attempting to meet and resolve them.
- Adheres to scope, timeliness, and sequence of processing in accordance with departmental standards, which are imbedded in the Morrisey work processes, jobs and tasks set-up, as well as Medical Staff Bylaws and related policies.
- Evaluate responses for identification of potentially adverse information. Application of established flagging criteria to verification responses for consideration in subsequent processing phases.
- Worklists files that deemed to meet required specifications for a complete file or an exhausted effort to Credentials Analysts (Quality Control). Performs additional work on or rework on files referred from Credentials Analyst.
- Monitors currency of credentials in conformance with established procedures including notifications to practitioner or other departments regarding delinquency and automatic suspension. Monitors disciplinary actions.
- Performs data entry of information into MSOW in accordance with established guidelines. Works accurately to assure the integrity of data entered MSOW. Utilizes MSOW including work processes, jobs and tasks and maintenance of fields in accordance with established standards. Completes training and maintains proficiency throughout MSOW development.
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Credentials Coordinator II - Los Angeles, United States - Cedars-Sinai
Description
Grow your career at Cedars-Sinai
Cedars-Sinai Medical Center has been ranked the #1 hospital in California by . News & World Report, 2023‐2024. Beyond an outstanding benefit package and competitive salaries.
We take pride in hiring the best, most passionate employees. Our talented doctors, nurses and staff reflect the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for.
What will you be doing in this role:
The Credentials Coordinator II works cooperatively to ensure the seamless and timely flow of credentialing related information to meet appointment and reappointment deadlines and qualitative requirements. Participates in effective day-to-day operations of the credentialing functions and provide recommendations to enhance productivity to meet targeted service levels, turnaround times, and satisfaction/quality levels. Assists in research and analysis of credentials files to complete SBARs for use by senior management and leadership for the Credentials Analysts. Maintains the integrity of the provider database for accurate display of information and accurate reports regarding credentialed providers and provides input for process design and other implementation activities.
Experience Requirements:
Three (3) plus years of experience in credentialing/privileging or health-related field and use of medical terminology and clinical nomenclature; or equivalent experience.
Proficiency in Microsoft 365 software applications to include use of menu-driven, word-processing, and spreadsheet applications.
Proven track record in an environment that requires accurate and consistent management of detailed data elements and management of discrete tasks to meet specified deadlines.
Educational/Licenses Requirements:
High School Diploma/GED.
Bachelor degree preferred.
Certified Provider Credentialing Specialist (CPCS) and/or Certified Medical Staff Coordinator (CMSC) preferred or to be obtained within 2-years of hire date.
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