Medical Staff Credential Coordinator

Presbyterian Healthcare Services; Albuquerque (NM); On-site; USD 50,000 - 75,000; Full time

Benefits offered by this job

Benefits package

Job summary

Presbyterian Healthcare Services is seeking a skilled Medical Staff Credential Coordinator to support credentialing and verification processes across Medical and Allied Health staff. The role ensures timely, compliant workflows, audits data accuracy, and acts as a subject matter expert for credentialing across departments.

Responsibilities include policy development, training, and coordinating with leadership to meet regulatory standards.

Qualifications

• Associate's degree/diploma in medical staff services or related field preferred.
• 3–5 years of experience in medical staff affairs/credentialing or related field preferred.
• Public relations skills to interact professionally with practitioners and customers.
• Excellent time management and organizational skills to handle multiple projects.
• Certification eligibility for CPMSM or CPCS preferred.

Responsibilities

• Assist with compliance with Medical Staff Bylaws, Rules/Regulations and daily CVO workflow.
• Develop policies and procedures to meet regulatory and accreditation requirements.
• Manage special projects as assigned.
• Support leadership to coordinate department responsibilities within long-range plans.
• Investigate discrepancies in credentialing data and determine appropriate actions.
• Provide excellent customer service to providers and clients.
• Maintain department quality indicators statistics.
• Train new and current employees on procedures and credentialing database.
• Serve as SME on national accrediting agencies and regulations.
• Maintain knowledge base of national accrediting agencies.

Skills

Credentialing

Public relations

Time management

Independent judgment

Education

Associate's degree/diploma in medical staff services

Job description

Location Address:

1100 Central Ave SEAlbuquerque, NM 87106-4930

Compensation Pay Range:

Minimum Offer $0.00Maximum Offer $0.00Now Hiring: Medical Staff Credential Coordinator

Summary:

Build your Career. Make a Difference. Presbyterian is hiring a skilled Medical Staff Credential Coordinator to support the Medical and Allied Health Staff credentialing/primary sourcing verification program by coordinating and developing internal processes in order to meet requirements of federal and state regulatory and national accreditation agencies. Monitors timeliness of processes and provides feedback and/or reports to the appropriate manager. Audits accuracy of data entry in the credentialing database and provides feedback to appropriate internal and external customers. This position requires in-depth knowledge of medical and allied health staff credentialing processes and requirements. Investigates issues of concern and conducts follow-up as needed, generates reports and presents findings to the Manager of Medical Staff Affairs (MSA) or Manager of Credentials Verification Organization (CVO). Serves as a subject matter expert to other PHS departments and facilities as it relates to the processing of initial and/or reappointment applications and/or privileging.Type of Opportunity: Full timeJob Exempt: YesJob is based: Presbyterian HospitalWork Shift: Days (United States of America)

Responsibilities:

This person will be responsible for assigned duties and responsibilities to ensure compliance with the Medical Staff Bylaws, Rules/Regulations and/ or the daily work flow of the CVO. Works with the appropriate manager in the development of policies and procedures to meet regulatory and accreditation requirements. Manages special projects as assigned

• Assists the Medical Director Department leadership in managing activities to ensure a coordinated effort to fulfill departmental responsibilities within its long-range plans and goals
• Exercises discretion and independent judgment involving the comparison and the evaluation of possible courses of action related to meeting primary source verification and credentialing requirements. Acts or reaches decisions independently after the various possibilities have been considered. * Investigates discrepancies in data submittal related to applications and privileging and formulates appropriate course of action.
• Provides excellent customer service by responding to provider, client, and customer inquiries within specified timeframes, as required by the department
• Maintains statistical information relative to the department s quality indicators
• Responsible for orientation/training of new and current employees as it relates to departmental procedures, credentialing database, and daily work
• Serves as a subject matter expert on appropriate national accreditation agencies and federal/state regulations pertaining to required credentialing processes
• Maintains knowledge base of appropriate national accrediting agencies

Qualifications:

• Associate s Degree/Diploma in medical staff services studies, or a related field preferred.
• Three to five years experience in medical staff affairs/credentialing, credentials verification organization, or related field preferred.
• Public relation skills required in order to be effective and behave in a professional manner when dealing with practitioners and customers.
• Requires excellent time management and organizational skills in order to handle multiple projects simultaneously.
• Certification or eligibility for certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred.
  

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.