Credentialing Specialist - Full Time - Day

Hackensack Meridian Health•North Bergen, NJ

1d•$30

About The Position

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Medical Staff Credentialing Specialist Initial will complete the credentialing process for new applicants to the Medical and Dental Staff from initial contact with the applicant through their final appointment in compliance with the Medical and Dental Staff Bylaws and Rules and Regulations, as well as with the appropriate accrediting and regulatory agencies.

Requirements

Bachelors Degree or 3 years credentialing experience in a Medical Staff Office with knowledge of medical credentialing and privileging procedures and standards, as well as knowledge of related accreditation and certification requirements.
Demonstrates reliability, tactfulness, honesty and discretion.
Demonstrates attention to detail and is able to prioritize multiple tasks.
Adapts to work schedules and frequent interruptions by demonstrating the ability to be flexible.
Demonstrates exemplary organizational skills while setting appropriate priorities.
Ability to communicate effectively, both orally and in writing.
Demonstrates exemplary communication skills.
Exemplifies excellent customer service skills.
Demonstrates critical thinking and problem solving skills.
Proficient in Google Workspace.
Excellent written and verbal communication skills.
Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

Nice To Haves

Knowledge of medical staff database programs.
NAMSS certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS).

Responsibilities

Monitors the initial appointment process for the Medical Staff ensuring compliance with regulatory bodies (The Joint Commission, CMS, federal and state), as well as the Medical Staff Constitution and Bylaws and Rules and Regulations.
Conducts background investigation, research and primary source verifications for applicants training, work history, licensure, certifications, hospital affiliations, claims history and peer evaluations.
Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
Prepares credentials file for presentation to the Credentials Committee, flagging any issues the Committee and/or Chairman may need to be alerted to.
Works closely with Department Chairs, administrators, physicians and applicants to facilitate resolution of credentialing issues and concerns.
Serves as facilitator for the Credentials Committee, meeting with the committee chair to review agenda issues prior to meeting.
Processes requests for privileges, ensuring compliance.
Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
Utilizes medical staff credentialing database, optimizing efficiency, and performs query, report and document generation. 11. Documents all actions of the Credentials Committee.
Processes all actions following approval by the Board of Trustees.
Covers for Medical Staff Specialist-Reappointments when needed.
Assist with numerous physician social and administrative functions hosted by the medical center.
Other duties and/or projects as assigned.
Adheres to HMH Organizational competencies and standards of behavior.