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Credentialing Coordinator

Saint Paul, Minnesota

Job ID: 9327 Category: Professional

Job Description

  • Processes and oversees the initial applications for clinical privileges and medical staff membership.
  • Coordinates and processes the practitioner reappointment process and incorporates the review of quality management performance reports and data obtained during the Ongoing Professional Practice Evaluation (OPPE) into the reappointment process.
  • Performs analysis of supporting documentation ensuring that applications are processed according to established policies and procedures as well as the Medical Staff Bylaws and Rules & Regulations, within the established time frame. Researches and identifies problems/issues regarding data integrity and reports to the Credentialing Director and/or the appropriate medical staff leader(s).
  • Assists with accreditation and department of health surveys and attends survey interviews as needed
  • Processes requests for additional clinical privileges according to established policy and procedures. Monitors, reviews and revises Delineation of Privilege Forms on a biannual basis.
  • Reviews all expirable items and ensures that all practitioner's licenses, DEAs, insurance, certifications, and other expiable items are current, valid and renewed by the practitioner by their due date.
  • Processes temporary privilege requests and applications for educational experiences.
  • Ensures that all applications have been fully and accurately processed prior to the Clinical Council Chair's review.
  • Interacts and communicates with practitioners, clinical council chairs and with various levels of management as necessary regarding credentialing/application processing and practitioner information and communicates information appropriate for the intended audience.
  • Maintains knowledge of, and complies with, all relevant laws, regulations and policies, procedures and standards.
  • Actively participates in creating and implementing improvements to achieve clinical, satisfaction and/or efficiency outcomes.
  • Other duties as assigned and for which I have been trained        

 

Qualifications:

  • High school graduate or equivalent
  • Certified Provider Credentialing Specialist (CPCS) preferred
  • Knowledge of analytical and/or statistical theory and applications. Ability to analyze data to interpret and evaluate results, and create reports and/or presentations.
  • Experience with Joint Commission, MN Department of Health and CMS survey processes.
  • Experience working with medical professionals.
  • Knowledge of health care environment, credentialing and medical staff organization.
  • Knowledge of Joint Commission and Centers for Medicare/Medicaid Medical Staff Standards.
  • Knowledge and skills in data collection, data analysis and interpreting results.
  • Knowledge and understanding of clinical events.
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