Medical Staff Credentialing Coordinator

Job Details

Description

General Summary:

Responsible for credentialing medical staff and health professional affiliates. Serves as an expert in Joint Commission standards, liaison to Board, Executive Staff, and Medical Staff Leadership. Exercises independent judgment in credentialing duties and medical staff issues. Supports Frederick Health’s mission and complies with the Frederick Health Standards of Behavior.

Essential Job Functions

Software Management

• Initiates requests for criminal background check
• Processes reappointments after Board Quality
• Initiates CredentialStream Onboard workflows for new providers
• Assign CBLs in NetLearning
• Initiate IPPE reviews 90 days post-orientation for physicians, 30 & 60 day reviews for APPs
• Initiates DrFirst e-prescribing requests
• Updates expirables:
• Specialty Boards, Certificates, Licenses, Malpractice Insurance
• Upload records into CredentialStream
• Discontinue user access upon resignation or suspension
• Reassign supervising physicians to if needed for Physician Assistants.
• CredentialStream report refinement
• CredentialStream troubleshooting and optimization
  

Communication

• Email deficiency notifications to physicians and APPs
• Initiate administrative suspension
• Communicate the restoration of administrative rights after suspension is lifted
• CDC quarterly Covid report
  

Credentialing Management

• Independently manages assigned aspects of appointment and credentialing
• Processes applications according to policies, bylaws, and regulatory requirements
• Performs primary source verification and NPDB queries
• Reviews privilege sets for appropriateness
• Tracks provider proctoring requests
• Ensures data availability for OPPE, FPPE, and reappointment
• Communicates application status to applicants
• Resolves application issues independently
• Prepares files for committee review
• Coordinates with HR for employed providers
• Maintains organized credential files for regulatory inspections
• Cross-references OIG Exclusions database
  
  

Medical Staff Coordination

• Maintains knowledge of Medical Staff Bylaws and hospital policies
• Attends and supports medical staff meetings
• Maintains CredentialStream database
• Generates provider reports and distributes as required
• Reviews provider activity to ensure privilege requirements are met
  
  

Minimum Qualifications

Education & Experience

• Associate's degree required
• 3 years of medical services experience
• CPCS is preferred and required within 1 year of hire
  
  

Skills & Abilities

• Advanced proficiency in MS Office (Word, Excel, PowerPoint, Outlook)
• Knowledge of credentialing software (preferably CredentialStream)
• Strong interpersonal communication and problem-solving skills
• Ability to work independently and meet deadlines
• Excellent organizational skills to manage multiple tasks
• Data interpretation and report creation skills
• High level of confidentiality
• Medical terminology knowledge
  
  

Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status. Possess the ability to interpret the appropriate information needed to identify each patient’s requirements relative to his/her age-specific needs and to provide the care needed as described in the unit’s/department’s policies and procedures – Not applicable.

Caring for you as you care for the CommUNITY

Frederick Health offers a comprehensive and affordable benefits package. Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your family's needs. Life insurance, Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees. All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.

Pay is based on experience, skills and education. If position is part-time, salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt positions may have shift differential and/or Overtime paid, if applicable.

Salary Range: $51,000 - $70,000