26113 - Medical Staff Coordinator

WVU Medicine Thomas Hospitals; South Charleston (WV); On-site; USD 40,000 - 70,000; Full time

Job summary

A regional health system seeks a Credentialing Coordinator to manage the credentialing and privileging processes for medical staff. The ideal candidate will handle applications, ensure compliance with standards, and maintain accurate records. Requirements include a degree in business or health-related field and relevant administrative experience. This role demands excellent organizational and communication skills, proficiency with office software, and the ability to work in a fast-paced environment.

Qualifications

• Bachelor’s degree in a relevant field with 1 year of experience, or an associate degree with 3 years of experience.
• High school diploma with 5 years of experience in an administrative setting.
• Three years of experience in a medical staff credentialing role.

Responsibilities

• Coordinate credentialing and privileging of medical staff.
• Maintain compliance with Joint Commission and NCQA standards.
• Perform primary source verifications of practitioner information.
• Enter and update practitioner information accurately in software.
• Participate in credentialing surveys.

Skills

Proficient computer skills

Organizational skills

Professional communication

Detail oriented

Ability to function in a fast-paced environment

Education

Bachelor’s degree in business or health-related field

Associate degree in business or health-related field

High school diploma or equivalent

Tools

Windows

Excel

Outlook

Job description

Job Summary

Coordinates and administers day-to-day support of the credentialing and privileging process for West Virginia University Hospitals and West Virginia United Health Systems. The process includes new applications, provisional reviews, and biennial reappointments for members of the Medical Staff, Licensed Independent Practitioners, and Advanced Practice Professionals as defined by the Hospital’s Medical Staff Bylaws.

Minimum Qualifications

• Bachelor’s degree in business or a health-related field AND one (1) year of experience in an administrative setting.
• Associate degree in business or a health-related field AND three (3) years of experience in an administrative setting.
• High school diploma or equivalent AND five (5) years of experience in an administrative setting.

Preferred Qualifications

• Bachelor’s degree in business or a health-related field.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Service Management (CPMSM) obtained within twelve (12) months of hire.

Experience

• Three (3) years’ experience in a medical staff credentialing role, preferably as a Medical Staff Coordinator or equivalent.
• Experience in a hospital or medical facility.

Core Duties and Responsibilities

• Coordinates the timely credentialing, recredentialing and privileging of new and current Physicians, Dentists, Licensed Independent Practitioners and Advanced Practice Professionals following Joint Commission and National Committee for Quality Assurance (NCQA) standards.
• Maintain working knowledge of Joint Commission, NCQA, State Medical Boards and Centers for Medicare & Medicaid Services (CMS) standards.
• Monitors and updates the credentialing process, including applications for appointment, reappointment, clinical privilege forms and policies to ensure compliance with Joint Commission, NCQA and CMS standards.
• Performs Primary Source Verifications of practitioner information in compliance with Joint Commission, NCQA and CMS standards.
• Enters, maintains and updates practitioner information into the electronic credentialing software in an accurate and timely manner.
• Maintains a current knowledge of the Medical Staff Bylaws, Rules & Regulations and Credentialing policies.
• Participates in Joint Commission, Office of Health Facility Licensure & Certification (OHFLAC) and Managed Care Organization (MCO) surveys as it relates to the credentialing and privileging of Physicians, Dentists, Licensed Independent Practitioners and Advanced Practice Professionals.
• Serves as the WVUH liaison to Managed Care Organizations in regard to performing delegated credentialing functions in accordance with contractual agreements.
• Work with Information Technology and the electronic credentialing software vendor to maintain a current system through updates and training.
• Participates in project work identified by the leadership of Medical Staff Affairs.

Physical Requirements

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Working Environment

• Standard office environment.

Skills & Abilities

• Ability to function in a demanding and fast-paced environment.
• Proficient computer skills including, but not limited to thorough knowledge and understanding of office software programs including Windows, Excel, Outlook, or similar applications.
• Possess excellent organizational and prioritization skills.
• Possess professional communication skills.
• Must be detail oriented and possess excellent spelling and grammar skills.

Additional Job Details

• Scheduled Weekly Hours: 40
• Shift: Day (United States of America)
• Exempt/Non-Exempt: United States of America (Non-Exempt)
• Cost Center: 404 THOM Medical Staff Affairs
• Address: 4605 Maccorkle Ave SW, South Charleston, West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.