Medical Staff Coordinator

Nashville General Hospital•Nashville, TN

5d•Onsite

About The Position

Nashville General Hospital is hiring a Medical Staff Credentialing Specialist for Physician Services as a full time Day Shift job in Nashville, Tennessee. Credentialing and Privileging Processes temporary privileges according to the Medical Staff Credentialing Policy, maintains detailed records about appointment timeframes and demographics Works closely with service line leaders to understand needs and schedules Works closely and professionally with the CVO to aid in the timely appointment, reappointment and addition of privilege processes Reviews practitioner’s privilege requests to verify that they meet established criteria, are within their scope of practice, and are presented accurately and in a prompt fashion to the Credentials Committee, Medical Executive Committee and the Board as directed Payer Enrollment Leads payer enrollment for new practice locations and entities in a professional and timely manner Completes and processes payer enrollment applications for Providers for Medicare and Medicaid and submits required information for delegated credentialing for the remaining insurance carriers, aligned with PHO policies and procedures Completes timely follow up on all applications Prepares and presents material for routine audits for delegated credentialing Maintains providers profiles and NPI’s, CAQH and internal spreadsheets Monitor and maintain current documents (licenses, malpractice insurance) Maintain confidentiality of all providers information General Routine Duties Ability to represent the Medical Staff Services and Nashville General Hospital in a positive and professional manner, understands and engages in the NGH philosophy of “managing up” across all levels of the organization Assists NGH leaders by coordinating medical staff support functions for the Medical Staff organization as outlined in the entity Medical Staff Bylaws and policies Supports all providers and external customers with finding solutions to concerns, and acts as a liaison between the providers and other hospital departments (IT, security, HR, administration) Coordinates and completes special projects promptly, appropriately prioritizes all tasks so that deadlines are met with continued focus on quality, and keeps all stakeholders apprised of any critical or major situations Maintains schedule for reviewing policies and procedures, and assists in policy revision process Assists in facilitating educational programs following ACCME accreditation guidelines Coordinates and maintains accurate on-call schedules for Emergency Department coverage, and a creates on-call schedules per contractual obligations and department rules and regulations Conducts physician onboarding to include processing paperwork needed for IT access, paperwork needed for badge, and physician orientation for all practitioners, residents and students as needed Conducts ID verification per the Medical Staff Credentialing Policy for all new Medical Staff members and privileged providers Coordinates all Medical Staff meetings, including General Medical Staff meetings, and responsible for scheduling room, catering requests, preparing attendance sheets, and minutes Participates in cross-training of new employees as needed to support department initiatives Other related duties as assigned

Requirements

Associate Degree in Business or Healthcare or equivalent combined professional training and experience
Two years of experience in Medical Staff Services as a Credentialing Specialist or Medical Staff Coordinator
In-depth knowledge of credentialing principles, processes, and standards, including NCQA, Joint Commission, and CMS requirements.
Strong analytical skills with the ability to interpret complex regulations and accreditation standards.
Expert level proficiency with Excel, Outlook and Word
Ability to work well in a team environment
Ability to triage priorities and handle conflict in a reasonable fashion with demonstrated time management skills
Project management skills needed to take lead role in new initiatives
Excellent communication skills, both written and verbal
Dependable with positive, service-oriented attitude
Proven ability to multitask with excellent diligence
NAMSS Certification or Dual Certification (CPCS or CPMSM) or actively pursuing certification with success within one year from hire date required

Nice To Haves

Bachelor’s degree in business or healthcare administration
Three years of experience in Medical Staff Services payer enrollment and credentialing
Demonstrated, expert level experience with Microsoft Office
Tri-Certification (CPMSM, CPCS, CPES) through the National Association of Medical Staff Services (NAMSS)

Responsibilities

Processes temporary privileges according to the Medical Staff Credentialing Policy, maintains detailed records about appointment timeframes and demographics
Works closely with service line leaders to understand needs and schedules
Works closely and professionally with the CVO to aid in the timely appointment, reappointment and addition of privilege processes
Reviews practitioner’s privilege requests to verify that they meet established criteria, are within their scope of practice, and are presented accurately and in a prompt fashion to the Credentials Committee, Medical Executive Committee and the Board as directed
Leads payer enrollment for new practice locations and entities in a professional and timely manner
Completes and processes payer enrollment applications for Providers for Medicare and Medicaid and submits required information for delegated credentialing for the remaining insurance carriers, aligned with PHO policies and procedures
Completes timely follow up on all applications
Prepares and presents material for routine audits for delegated credentialing
Maintains providers profiles and NPI’s, CAQH and internal spreadsheets
Monitor and maintain current documents (licenses, malpractice insurance)
Maintain confidentiality of all providers information
Ability to represent the Medical Staff Services and Nashville General Hospital in a positive and professional manner, understands and engages in the NGH philosophy of “managing up” across all levels of the organization
Assists NGH leaders by coordinating medical staff support functions for the Medical Staff organization as outlined in the entity Medical Staff Bylaws and policies
Supports all providers and external customers with finding solutions to concerns, and acts as a liaison between the providers and other hospital departments (IT, security, HR, administration)
Coordinates and completes special projects promptly, appropriately prioritizes all tasks so that deadlines are met with continued focus on quality, and keeps all stakeholders apprised of any critical or major situations
Maintains schedule for reviewing policies and procedures, and assists in policy revision process
Assists in facilitating educational programs following ACCME accreditation guidelines
Coordinates and maintains accurate on-call schedules for Emergency Department coverage, and a creates on-call schedules per contractual obligations and department rules and regulations
Conducts physician onboarding to include processing paperwork needed for IT access, paperwork needed for badge, and physician orientation for all practitioners, residents and students as needed
Conducts ID verification per the Medical Staff Credentialing Policy for all new Medical Staff members and privileged providers
Coordinates all Medical Staff meetings, including General Medical Staff meetings, and responsible for scheduling room, catering requests, preparing attendance sheets, and minutes
Participates in cross-training of new employees as needed to support department initiatives
Other related duties as assigned

Benefits

Medical, Dental, and Vision Insurance within first 31 days of employment
Programs to reduce share of deductible and total out-of-pocket expenses
Metro Health Incentive Program - Access to high quality healthcare without incurring out-of-pocket expenses
Short and Long-Term Disability - up to 60% of eligible weekly pay
Life Insurance - Metro provides you with basic life and AD&D coverage equal to $50,000 ($32,500 if you are age 65 or older), at no cost to you.
401K Retirement Plan - eligible up to IRS max limits and includes company contribution
Shift and Weekend Differential Pay Offered on Nights and Weekends
Tuition Reimbursement for employee and dependents
12 paid holidays - any holiday worked is another holiday banked
Flexible Spending Accounts
Free Parking for all employees