Credentialing and Medical Staff Coordinator

UT Southwestern Medical Center • Dallas, TX

10d • Onsite

About The Position

The Credentialing Specialist for the Department of Surgery is responsible for the timely processing of initial credentialing and recredentialing for faculty, fellows, residents, and other healthcare practitioners. This role supports new providers by coordinating licensing requirements and providing guidance throughout the credentialing process. The specialist collaborates with hospitals and managed care organizations to ensure accurate and timely provider enrollment, credential verification, and updates to practitioner information. Additionally, the position maintains and tracks credentialing, licensing, provider enrollment, and managed care records to ensure compliance and continuous provider participation.
The role of the professional Credentialing and Medical Staff Coordinator is to utilize both critical thinking skills and involves the exercise of discretion and independent judgment with the performance of his/her work in the servicing of the Hospitals' and Campus' credentialing and privileges processes.

Requirements

• High School Diploma or equivalent, and knowledge of anatomy, physiology, medical terminology and The Joint Commission (TJC) standards or Associate's Degree Completion of a specialized training program in the field of medical staff credentialing (i.e. Associate Degree in Credentialing)
• 2 years Experience in the field of medical staff credentialing, or Completion of a specialized training program in the field of medical staff credentialing (i.e. Associate Degree in Credentialing)

Nice To Haves

• (CPCS) CRT PROVIDER CREDENT SPEC Certification by the National Association of Medical Staff Services at time of employment Upon Hire or
• (CPMSM) Cert Prof Medical Staff Mgmt Certification by the National Association of Medical Staff Services at time of employment Upon Hire

Responsibilities

• Manages the distribution and receipt of credentialing and privileging applications, peer review forms and continuous updating of Departments' privilege form to reflect current privileges and corresponding privileging criteria.
• Serves as a professional resource for Departments' Credentialing Contacts, Physicians/Practitioners, Credentials and Medical Executive Committees and the Health System Board regarding the credentialing and privileging process including new applications, any privilege form or criteria changes, and reporting status with the processing of all files.
• Solely responsible for reviewing the content of the completed evaluation forms which includes verification of applicants' education, training, board certification, licensure, other certifications and past work history.
• Identifies any discrepancy, erroneous information and/or issues of impairment (health, drug, alcohol, etc.) from the application based on the results of the primary source verification. After seeking clarification, responsible for reporting findings to Credentials Committee.
• Reports to the Department Chair/Designee any instances where the privileging criteria are not met. Verifies status with Federal and State sanctions. Reports any sanctions found to manager, director and Chief Medical Officer.
• Issues all letters associated with the appointment and any necessary requests for computer access, FNEA numbers for the physician, upon notification of approval by the Health System Board.
• Responsible for meeting required performance metric relating to the timely processing of applications and managing individual workload to prevent late reappointments, or delayed initial appointments.
• Maintains and validates the accuracy of the physician profiles in the hospitals' and Managed Care Organizations credentialing database system to accurately reflect status, findings of credentialing process, and hospitals' financial and coding systems.
• Generates varies reports and completes special projects as assigned and in a timely manner.
• 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