Credentialing Asst. FT On-Site

Job Purpose: 

Education & Qualifications: HS diploma or equivalent required. Associate degree preferred. with at least.

Preferred Licenses/Certifications: Not required on hire, but would support the incumbent to secure Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional in Medical Services Management (CPMSM)

Work Experience: 2 years of experience in Medical Staff services preferred. USMD will consider fresh college graduates interested in pursuing career in medical staff services.

Skills:

• Excellent verbal and written communication skills
• Medical terminology or healthcare knowledge a plus
• Microsoft suite skills (Word, Excel, and PowerPoint)
• Analytic skills
• Experience with MD-Staff solution or similar solutions is preferred.

Physical Demands & Working Conditions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job the employee is regularly required to use hands to finger, grasp, handle, or feel and to reach with hands and arms. The employee is frequently required to sit, stand, walk, see, speak, and hear. The employee is occasionally required to kneel, climb, or balance. The employee is regularly required to lift up to 10 pounds and rarely lift more than 25 pounds.

Essential Duties and Responsibilities:

• Ensures accuracy and currency of medical staff information in the MD-Staff solution.
• Audits provider profiles in MD-Staff on regular basis and reports to the specialist any identified deficiencies or discrepancies.
• Prepares and analyzes MD-Staff reports, as needed.
• Assists the specialist with application, appointment, and reappointment tasks.
• Analyzes applications for completeness and accuracy.
• Assists in obtaining necessary material and/or information necessary to process provider application. Coordinates with provider’s administrative staff, as needed.
• Tracks provider CME requirements and notifies the specialist of any deficiencies or discrepancies.
• Collects and collates data for physician performance [Focused Physician Performance Evaluation (FPPE), and Peer Review].
• Prepares and reviews Meditech Expanse reports for physician performance evaluation purposes.
• Enters physician performance evaluation data into the MD-Staff solution.
• Assists the specialist with activities related to medical staff meetings.
• Works with the Specialist to obtain necessary documentation from Medical Staff including but is not limited to completed applications, licenses, insurance information, activity logs, immunization, CME, and primary source verification.
• Monitors the initial, reappointment hospital applications and expirations process for providers and notify providers of licensing expirations and monitor to ensure timely renewals.
• Updates provider and facility information in external licensing and credentialing databases/organizations.
• Send, receive and process applications of providers and facilities due for credentialing and re-credentialing.
• Respond to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing issues as they arise
• Assists with the Clinical Observation experience, as needed,
• Promotes and maintains positive working relations with providers and internal departments.
• Maintains current knowledge of Joint Commission medical staff standards as well as state and federal requirements.
• Assists in preparing MSO reports, as needed.
• Ensures and maintains compliance to applicable standards.
• Maintains confidentiality of Medical Staff information.
• Attends all mandatory education programs and can describe his/her responsibilities related to general safety and regulatory compliance. 
• Attends all required department-specific education and training programs and can describe his/her responsibilities related to department safety and specific job‑related hazards.
• Performs other duties as assigned.