CREDENTIALING COORDINATOR

Fort Defiance Indian Hospital Board, Inc.•Fort Defiance Agency, AZ

5h•$26 - $32•Onsite

About The Position

This role is responsible for ensuring the proper execution of the credentialing and privileging process for the Medical Staff. This includes managing requests for appointment, reappointment, expansion or reduction of privileges, temporary membership, temporary privileges, and verification of current licensure. The position also ensures compliance with Centers for Medicare and Medicaid Services (CMS) requirements, FDIHB credentialing policies, and FDIHB Bylaws of the Medical Staff. The Credentialing Coordinator will maintain a computerized database for timely notification of reappointments and licensure expiration, oversee background research on applications, and prepare various reports and materials.

Requirements

Applicant must have a valid, unrestricted insurable driver's license.
Resumes and references are required.
One (1) year of direct experience in credentialing and medical staff privileging.
Associate degree or equivalent experience.

Responsibilities

Ensures the proper execution of the credentialing and privileging process for the Medical Staff, including requests for appointment, reappointment, expansion or reduction of privileges, temporary membership, temporary privileges, and verification of current licensure.
Ensures compliance with Centers for Medicare and Medicaid Services (CMS) requirements, FDIHB credentialing policies and FDIHB Bylaws of the Medical Staff.
Assists with maintaining the Medical Services Division position control master for all positions.
Assists with coordinating and preparing Personal Services Contracts and non-PCS contracts for medical services.
Ensures that an accurate, current, and confidential computerized database for timely notification for reappointments and licensure expiration is maintained.
Oversees and completes background research on all applications such as: Verification of education, training and experience; Obtaining reference from other hospitals and health professionals; Verification of state license(s); Verification of malpractice concerns via National Practitioner Data Bank (NPDB) and other sources; Verification of Continuing Medical Education (CME); Verification of current competence and professional conduct through peer recommendations.
Effectively utilize hospital credentialing software to perform essential job functions, adhering to established formats and standards.
Performs data entry of information into the credentialing software while assuring the system is accurate and up-to-date in real time.
Provides notification to medical staff of any expiring license, board certification, and Drug Enforcement Agency (DEA) number.
Completes further investigation as requested by the Medical Executive Committee and/or Governing Board.
Prepares and distributes Medical Executive Committee (MEC) list for appointment, reappointment for permanent, temporary and consulting staff.
Provides general medical staffing reports as requested by the Chief Medical Officer and Chief of Staff.
Provide regular communication with the Provider Enrollment Team and Medical Staff Recruiter and other team members to ensure a timely provider onboarding.
Coordinates Medical Staff Meetings.
Organizes the flow of the credentialing process in the Medical Division.
Receives telephone calls and visitors; screens inquiries, takes care of routine matters, referring callers/visitors to appropriate personnel.
Establishes and maintains an efficient filing system for the credentialing documentation.
Prepares a variety of materials such as correspondence, reports, technical documents, requisitions, forms, meeting minutes and memos using automated systems.
Receives reviews and distributes incoming correspondence related to the medical staff credentialing.
Maintains control of correspondences and action documents to enable follow-up status and/or progress to ensure timely action in accordance with established requirements and deadlines.
Performs other duties as assigned.