Credentialing Coordinator
Hallmark Global Solutions Ltd
Credentialing Coordinator
Schedule:Day 5x8-Hour (08:00 - 17:00) Job Location:
1700 E 19th St
The Dalles, OR 97058 Job Summary:
Coordinates and processes all medical staff applications for appointment/reappointment for assigned areas of responsibility, according to established procedures. Coordinates physician initial application appointment process for the organization in accordance with the Joint Commission on the Accreditation of Health care Organizations (JCAHO) standards and medical bylaws. Acts as liaison between organization administration and the Medical Staff. Coordinates small program(s) with limited budget/impact.
Job Requirements
High School Education/GED or equivalent
Five years' relevant experience: Preferred
Healthcare industry experience: Preferred
Commercial healthcare experience: Preferred
Facility Specific License/Certifications:
Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS): Required
Essential Functions:
Initiates letters of inquiry regarding education, training, personal medical references, staff affiliations, board certifications, out-of-state licensure and relevant information. Requests verification from the Medical Board of California for current state licensure. Queries the National Practitioner Databank. Creates confidential files on new practitioners and obtain copies of state licensure/s and certificates, if applicable.
Conducts thorough background investigation, research and primary source verification of all components of the application file. Performs primary source verification of all necessary elements through letters or faxes, websites, telephone verifications or equivalent sources.
Follows up on all incomplete or problematic information in a timely and consistent manner. Ensures that all reappointments are completed and reviewed by the appropriate credentialing entity before expiration date. Tracks license and certification expirations for all providers to ensure timely renewals.
Assists with conducting an annual review of Medical Staff Bylaws, rules and regulations and all documents pertinent to the medical staff who are maintained in the department. Submits sections for revisions to appropriate committees. Keeps current with legal issues necessary for implementation of the bylaws etc. Oversees provider information in online credentialing databases and system.
Performs other job-related duties as assigned.
Vacancy posted 4 days ago
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