UHC - Medical Staff Coordinator

UHC United Hospital Center; Bridgeport (WV); On-site; USD 42,000 - 60,000; Full time

Job summary

UHC United Hospital Center in Bridgeport, WV seeks a Credentialing Coordinator to manage the credentialing and privileging process for medical staff and APPs in accordance with Joint Commission, NCQA and CMS standards.

The role requires strong organizational skills, proficiency in Office apps, and meticulous data management. Prior credentialing experience is preferred; CPCS or CPMSM certification is a plus and may be achieved within 12 months of hire.

Qualifications

• Bachelor’s degree with 1 year admin experience
• Associate degree with 3 years admin exp.
• High School diploma with 5 years admin exp.

Responsibilities

• Coordinate credentialing and privileging per Joint Commission, NCQA, CMS standards.
• Perform primary source verifications of practitioner information.
• Maintain practitioner data in credentialing software.
• Stay updated on Medical Staff Bylaws, Rules & Regulations and credentialing policies.
• Assist in Joint Commission, OHFLAC and MCO surveys as needed.
• Liaise with Managed Care Organizations regarding delegated credentialing functions.

Skills

Computer skills

Organization

Communication

Detail-oriented

Fast-paced

Education

Bachelor’s degree in business or health-related field

Associate degree in business or health-related field

High School diploma with 5 years experience

CPCS or CPMSM certification within 12 months

Tools

Microsoft Excel

Outlook

Credentialing software

Job description

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position.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, but is not limited to, 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:EDUCATION, EXPERIENCE, CERTIFICATION, AND/OR LICENSURE:1. Bachelor’s degree in business or a health-related field AND one (1) year of experience in an administrative setting.ORAssociate Degree in business or a health-related field AND three (3) years of experience in an administrative setting.ORHigh School Diploma or equivalent AND five (5) years of experience in an administrative setting.PREFERRED QUALIFICATIONS:EDUCATION, CERTIFICATION, AND/OR LICENSURE:1. Bachelor’s Degree in business or a health-related field.2. Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Service Management (CPMSM) OR obtained within twelve (12) months of hire.EXPERIENCE:1. Three (3) years’ experience in a medical staff credentialing role, preferably as a Medical Staff Coordinator or equivalent.2. Experience in a hospital or medical facility.CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.1. 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.2. Maintain working knowledge of Joint Commission, NCQA, State Medical Boards and Centers for Medicare & Medicaid Services (CMS) standards.3. 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.4. Performs Primary Source Verifications of practitioner information in compliance with Joint Commission, NCQA and CMS standards.5. Enters, maintains and updates practitioner information into the electronic credentialing software in an accurate and timely manner.6. Maintains a current knowledge of the Medical Staff Bylaws, Rules & Regulations and Credentialing policies.7. 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.8. Serves as the WVUH liaison to Managed Care Organizations in regard to performing delegated credentialing functions in accordance with contractual agreements.9. Work with Information Technology and the electronic credentialing software vendor to maintain a current system through updates and training.10. 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: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.1. Standard office environmentSKILLS & ABILITIES:1. Ability to function in a demanding and fast-paced environment.2. Proficient computer skills including, but not limited to thorough knowledge and understanding of office software programs including Windows, Excel, Outlook, or similar applications.3. Possess excellent organizational and prioritization skills.4. Possess professional communication skills.5. Must be detail oriented and possess excellent spelling and grammar skills.Additional Job Description:Scheduled Weekly Hours:40Shift:Exempt/Non-Exempt:United States of America (Non-Exempt)Company:UHC United Hospital CenterCost Center:404 UHC Medical Staff AffairsAddress:327 Medical Park DriveBridgeportWest VirginiaEqual Opportunity EmployerWest 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.