Credentialing and Medical Staff Coordinator Sr

UT Southwestern Medical Center • Dallas, TX

20h

About The Position

Works under minimal supervision to perform functions related to credentialing and privileging of physicians and other practitioners.

Requirements

• High School Diploma or equivalent, knowledge of anatomy and physiology, medical terminology, knowledgeable of both NCQA and JCAHO standards, and parliamentary procedures
• 3 years experience or equivalent knowledge in the field of medical staff credentialing
• (CPCS) CRT PROVIDER CREDENT SPEC Upon Hire or
• (CPMSM) Cert Prof Medical Staff Mgmt Upon Hire

Nice To Haves

• 5 years years of Medical Staff/Managed Care credentialing experience.

Responsibilities

• Completes the initial appointments and reappointments for the Faculty and Community-based physicians of the assigned Department(s).
• Completes the required follow-up work associated with the approval of the initial appointment or reappointment. This includes the issuance of a Board letter, the entering of privileging into the database, and completion a final review of the physical file and data entry.
• Generates the required physician profile to validate volume/activity requirements and to validate volume requirements associated with specific privilege criteria.
• Conducts reviews of managed care documentation and policies. Completes necessary revisions and prepares the documents for submission for approval.
• Conducts required reports or audits. Maintains documentation of review activity as required by NCAQ standards.
• Reviews findings of reports or audits with the Manager and/or staff members.
• Completes projects as assigned and in a timely manner.
• Maintains knowledge of and compliance with Joint Commission/NCQA standards for Medical Staff.
• Performs other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED