MEDICAL STAFF OFFICE - CREDENTIALING SPECIALIST

Mountain View Hospital; Idaho Falls (ID); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical, Dental and Vision Insurance

Paid Time Off (PTO) and Medical PTO

401K with up to 6% match

Earned Quarterly Bonus Program

Education Reimbursement

Job summary

Mountain View Hospital in Idaho Falls seeks a Credentialing Specialist to ensure medical staff compliance with Idaho CMS standards and hospital Rules and Regulations. You will credential new providers, manage bi-annual recredentialing, and prepare materials for staff evaluations and reviews.

You will support the compliance department with data collection, reporting, and statistical evaluations while coordinating with the Credentialing Committee and Board of Managers.

Qualifications

• Medical clerical experience preferred.
• Must be able to work well under pressure and multi-task.

Responsibilities

• Compile initial and re-credentialing packets.
• Distribute credentialing packets.
• Verify external affiliations and peer evaluations.
• Gather licensure, education certificates, certifications, CME credits, and health information.
• Search NPDB and other agencies for provider information.
• Review credentialing files with Chief Compliance Officer and Medical Staff leadership.
• Prepare documentation for Credentialing Committee and Board of Managers.
• Maintain provider information in hospital databases.

Skills

Medical clerical experience

Under pressure

Multi-tasking

Education

High School diploma or equivalent

CPCS/CPMSM certification (or pursuing)

Job description

Mountain View Hospital is looking for a Credentialing Specialist to join our team!

Job Summary

Ensure all members of the Mountain View Hospital medical staff are compliant according to Idaho CMS standards and the Rules and Regulations of Mountain View Hospital. Credential all new provider files for Mountain View Hospital’s Credentialing Committee and Board of Managers. Complete bi-annual recredentialing requirements of existing staff members. Prepare all documentation and materials needed for medical staff evaluations and review processes. Assist in medical staff management when needed. Monitor all providers within facility and those requesting patient information outside of the facility. Assist in quality assurance and compliance measures by tracking and standardizing all orders and forms within the facility. Assist the compliance department with all data collection, data reporting and statistical evaluations.

Benefits

Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:

• Medical, Dental and Vision Insurance
• Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
• Retirement Plans (401K with up to 6% match)
• Earned Quarterly Bonus Program
• Education Reimbursement Program
• Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.

Duties And Responsibilities

• Compilation of initial and re-credentialing packets.
• Distribution of initial and re-credentialing packets.
• Verify all providers outside affiliations and peer evaluations.
• Gather all required medical licensure, certificates of education, board certifications, continued medical education (CME) credits, and health background information.
• Search National Practitioner Data Bank, America Medical Association and any other investigative agencies for further provider information.
• Review all credentialing files with Chief Compliance Officer prior to Credentialing Committee.
• Review files with Chief of Medical Staff when asked to do so.
• Prepare all documentation for Mountain View Hospital Credentialing Committee and Board of Managers.
• Inform all initial and re-credentialed applicants of staff status once Board of Managers is completed.
• Update provider’s information in hospital databases including physician database, intranet, CPSI.
• Create, disseminate and research information regarding clinical procedures and delineations.
• Inform and brief all department managers on new medical staff members.
• Refer all new providers to the Physician Liaison for dynamic voice numbers and hospital tours.
• Investigate all visiting providers within the facility.
• Verify all provider information outside of the facility when patient is admitted to Mountain View Hospital for outpatient procedures.
• Trend all occurrences that directly correlate with members of the medical staff.
• Assist Chief Compliance Officer in data collection and presentation of all materials for Medical Executive Committee.
• Distribute additional information to all medical staff members following Medical Executive Committee when deemed necessary.
• Assist Chief Compliance Officer in overseeing all focused professional practice evaluations (FPPE) and peer review processes.

About Mountain View

Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.

Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.

Qualifications

Education/Certification: High School graduate or equivalent.

Experience: Medical Clerical experience preferred. Must hold or work towards certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medial Services Management (CPMSM) or work towards obtaining certification.

Performance: Be able to work well under pressure. Must be able to multi-task.