Credentials Coordinator

Luminis Health, Inc.; Annapolis (MD); Presencial; USD 31.000 - 47.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical Insurance

Retirement Plan

Paid Time Off

Tuition Assistance

Descripción de la vacante

Luminis Health, Inc. seeks a dedicated professional to lead the Medical Staff Credentialing and Privileging System, coordinating initial appointments, reappointments, and privileging for practitioners in a compliant manner.

The role requires strong organizational and communication skills, plus 3–5 years in medical staff credentialing; CPCS/CPMSM certification is preferred. This full-time position supports on-site operations and collaboration with the Credentials Committee.

Formación

• High school diploma; Associate degree preferred.
• Excellent organizational, verbal and written communication skills required.
• MS Office Suite (Word, Excel, Access, Outlook) and Internet/Web proficiency; 2+ years supervisory/lead experience preferred.
• Demonstrated ability to delegate tasks and ensure accuracy of tasks.
• 3–5 years related work experience in Medical Staff Office or hospital credentialing preferred.

Responsabilidades

• Enter and edit data in the credentialing and privileging system with timely turnaround.
• Initiate and follow through on all aspects of credentialing and privileging including initial and re-credentialing.
• Coordinate processing of applications for initial appointment and reappointment; review and input data.
• Ensure primary source verification of background checks using online systems and references.
• Provide issue resolution support to practitioners and respond to internal and external customers.

Conocimientos

Organizational skills

Verbal and written communication

Supervisory/lead experience

Interpersonal skills

Educación

High school diploma

Associate degree preferred

Herramientas

MS Office Suite (Word, Excel, Access, Outlook)

Internet/Web

Descripción del empleo

Position Objective

Primary responsibility for the implementation of the Medical Staff Credentialing and Privileging System. Coordinates all aspects of the medical staff credentialing process for new appointments, reappointments and privileging. Monitors all aspects of the process to ensure compliance with regulatory and Joint Commission standards and Medical Staff Bylaws.

Essential Job Duties

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

1. Accurately enters and edits data in the credentialing and privileging system. Ensures turn-around-time throughout the credentialing and privileging process as defined in the Medical Staff Bylaws
2. Initiates and follows through on all aspects of credentialing and privileging including the initial and re-credentialing process for all practitioners. Able to run database queries and reports to support efficiencies and prioritization of workflow
3. Coordinates the processing of incoming applications for initial appointment, and reappointment. Reviews applications thoroughly and enters data in the automated database. Reviews data for accuracy and integrity
4. Ensures completion of primary source verification of practitioner’s background through the use of on-line systems, written correspondence, telephone inquiries and printed reference guides, rosters and reports.
5. Provides assistance and determines resolution to practitioner issues and/or triages appropriately, via verbal/written communication in response to both internal and external customers. Identifies and responds pro-actively to issues and concerns assuring complete solutions in a timely manner. Identifies and evaluates for potential red flags and works in collaboration with the Supervisor to determine next steps
6. Ensures FPPE process is completed for all Medical Staff members following initial appointment and for those exercising new privileges; performs analysis of report data.
7. Secures OPPE reports to be utilized in the credentialing and privileging process; performs analysis of report data
8. Responsible for preparation of materials and files for presentation and review by the Credentials Committee. Provides back-up support to the Lead Credentials Coordinator related to credentialing and privileging action and/or information items presented to the credentials Committee, Medical Executive Committee and Board of Trustees; support includes, but is not limited to: preparation of meeting agendas, preparation of meeting minutes, preparation of packets and ensuring follow-up to all action items
9. Follows through with notification to the Medical Staff Member after Board of Trustees approval of initial appointment, and reappointment to the Medical Staff. Notifies AAMC staff via Outlook of initial appointment of Medical Staff members or changes in Medical Staff Members privileges.
10. Performs expedited credentialing as directed by Lead Credentials Coordinator. Ensures that all licensure, insurance and certification requirements are current. Facilitates on boarding of all new members of the Medical Staff.

Educational/Experience Requirements

• High school diploma. Associate degree preferred.
• Excellent organizational, verbal and written communication skills required.
• Must be proficient in MS Office Suite (Word, Excel, Access, Outlook) and Internet/Web. Minimum of two (2) years Supervisory/Lead experience preferred.
• Demonstrated ability to delegate tasks and ensure accuracy of tasks.
• Three (3) to five (5) years related work experience in a Medical Staff Office or hospital credentialing strongly preferred.

Required License/Certifications

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification by the National Association of Medical Staff Services is strongly preferred.

Working Conditions, Equipment, Physical Demands

There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

Physical Demands

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.

The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Pay Range

$22.55 — $33.83 USD

Luminis Health Benefits Overview

• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more

*Benefit offerings based on employment status