Credentialing Coordinator

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Responsible for obtaining and verifying all required and pertinent credentialing and recredentialing documentation. Works with staff and hospital system leadership to ensure that applicants have proper credentials and training to provide patient care. Performs all duties in accordance with the Medical Staff policies, bylaws, rules, and regulations. Follows legal, state and federal agency, state licensing board, Joint Commission and Risk Management regulations or guidelines. Minimum Education: High School Diploma or GED. College Degree in related field preferred. Licensure, Registration and/or Certification: None. Work Experience: Minimum of 1 year of related experience preferred. Knowledge, Skills and Abilities: Ability to organize, be self-motivated and professionally manage demanding workload with frequent interruptions. Ability to utilize assertive and political intuitiveness skills. Effective, professional interpersonal, written and verbal communication skills. Ability to be detail oriented with independent thinking and judgment skills. Ability to operate general office machines and utilize PC applications. Essential Functions and Responsibilities: Assists Credentials Chairman and Supervisor Medical Staff Services in the development of privilege documents, credentialing policies and rules and regulations. Completes additional duties and special projects as assigned. Coordinates the process of appointment, reappointment and credentialing for the medical staff, allied health professionals to ensure compliance with Joint Commission and State and Federal requirements. Ensures accurate documentation and verification of information in compliance with Joint Commission standards and the bylaws and credentialing policies of the Medical Staff. Ensures compliance with National Practitioners Data Bank Guidelines. Works with other credentialing personnel to initiate background checks for all applicants, verification of education, experience, and licensure by using on-line systems, written correspondence, telephone inquiries and printed reference questionnaires and reports. Works with supervisor medical staff services in designing and implementing systems for compiling, maintaining and retrieving complete and confidential records relating to all activities of the medical staff. Performs ongoing environmental surveillance to identify new requirements or opportunities to share information and collaborate with other groups; communicates these opportunities as appropriate. Maintains a thorough understanding of medical staff organizations and organizational documents including bylaws, rules and regulations and credentialing policies, Joint Commission standards, State and Federal regulations affecting the Medical Staff organization; hospital organizational structure, organizational policies and procedures; and legal issues affecting the medical staff. Assists Supervisor Medical Staff Services in supporting medical staff meetings such as the Medical Executive Committee and Credentials Committee. Including but not limited to, providing documentation of meeting minutes, ensuring follow-up action is taken, providing monthly updates on credentialing activities, etc. Serves as a resource for various internal departments providing information regarding credentialing issues, clinician privileges, and changes to health plan participation, and maintaining accurate databases of provider information. Decision Making: The carrying out of non-routine procedures under constantly changing conditions, in conformance with general instructions from supervisor. Working Relationships: Coordinates activities of others (does not supervise). Works directly with patients and/or customers. Works with internal customers via telephone or face to face interaction. Works with external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Works frequently with individuals at Director level or above. Special Job Dimensions: None.

Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job.

This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.