MEDICAL STAFF OFFICE - CREDENTIALING SPECIALIST

MOUNTAIN VIEW HOSPITAL LLC • Idaho Falls, ID

2d • Onsite

About The Position

Mountain View Hospital is looking for a Credentialing Specialist to join our team! This role is responsible for ensuring all members of the Mountain View Hospital medical staff are compliant with Idaho CMS standards and the hospital's Rules and Regulations. The Credentialing Specialist will credential new provider files for the Credentialing Committee and Board of Managers, complete bi-annual recredentialing for existing staff, and prepare documentation for medical staff evaluations. The position also involves assisting in medical staff management, monitoring providers, aiding in quality assurance and compliance by tracking orders and forms, and supporting the compliance department with data collection and reporting.

Requirements

• High School graduate or equivalent.
• Medical Clerical experience preferred.
• Must hold or work towards certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medial Services Management (CPMSM) or work towards obtaining certification.
• Be able to work well under pressure.
• Must be able to multi-task.

Responsibilities

• Ensure all members of the Mountain View Hospital medical staff are compliant according to Idaho CMS standards and the Rules and Regulations of Mountain View Hospital.
• Credential all new provider files for Mountain View Hospital’s Credentialing Committee and Board of Managers.
• Complete bi-annual recredentialing requirements of existing staff members.
• Prepare all documentation and materials needed for medical staff evaluations and review processes.
• Assist in medical staff management when needed.
• Monitor all providers within facility and those requesting patient information outside of the facility.
• Assist in quality assurance and compliance measures by tracking and standardizing all orders and forms within the facility.
• Assist the compliance department with all data collection, data reporting and statistical evaluations.
• Compilation of initial and re-credentialing packets.
• Distribution of initial and re-credentialing packets.
• Verify all providers outside affiliations and peer evaluations.
• Gather all required medical licensure, certificates of education, board certifications, continued medical education (CME) credits, and health background information.
• Search National Practitioner Data Bank, America Medical Association and any other investigative agencies for further provider information.
• Review all credentialing files with Chief Compliance Officer prior to Credentialing Committee.
• Review files with Chief of Medical Staff when asked to do so.
• Prepare all documentation for Mountain View Hospital Credentialing Committee and Board of Managers.
• Inform all initial and re-credentialed applicants of staff status once Board of Managers is completed.
• Update provider’s information in hospital databases including physician database, intranet, CPSI.
• Create, disseminate and research information regarding clinical procedures and delineations.
• Inform and brief all department managers on new medical staff members.
• Refer all new providers to the Physician Liaison for dynamic voice numbers and hospital tours.
• Investigate all visiting providers within the facility.
• Verify all provider information outside of the facility when patient is admitted to Mountain View Hospital for outpatient procedures.
• Trend all occurrences that directly correlate with members of the medical staff.
• Assist Chief Compliance Officer in data collection and presentation of all materials for Medical Executive Committee.
• Distribute additional information to all medical staff members following Medical Executive Committee when deemed necessary.
• Assist Chief Compliance Officer in overseeing all focused professional practice evaluations (FPPE) and peer review processes.

Benefits

• Medical, Dental and Vision Insurance
• Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
• Retirement Plans (401K with up to 6% match)
• Earned Quarterly Bonus Program
• Education Reimbursement Program
• Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

What This Job Offers

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