Medical Staff Credential Coordinator

Presbyterian System Services • Albuquerque, NM

1d • Onsite

About The Position

Presbyterian Healthcare Services is hiring a Medical Staff Credential Coordinator to support credentialing and primary-source verification for Medical and Allied Health Staff. The role coordinates and develops internal processes to meet federal and state regulatory requirements and national accreditation standards. It monitors process timeliness, audits credentialing database entries for accuracy, provides feedback and reports, investigates concerns, and presents findings to the Manager of Medical Staff Affairs or Manager of Credentials Verification Organization. The coordinator also serves as a subject matter expert for Presbyterian departments and facilities on initial and reappointment applications and privileging.

The position supports compliance with Medical Staff Bylaws, Rules and Regulations, and the daily workflow of the Credentials Verification Organization. It works with management on policies and procedures, handles special projects, supports departmental leadership, investigates application and privileging discrepancies, maintains quality statistics, and provides training and customer service. The role requires in-depth knowledge of medical and allied health staff credentialing processes and applicable regulations.

Requirements

• Associate's degree or diploma in medical staff services studies or a related field preferred.
• Three to five years of experience in medical staff affairs/credentialing, a credentials verification organization, or a related field preferred.
• Public relations skills to interact effectively and professionally with practitioners and customers.
• Excellent time-management and organizational skills to handle multiple projects simultaneously.
• In-depth knowledge of medical and allied health staff credentialing processes and requirements.

Nice To Haves

• Associate's degree or diploma in medical staff services studies or a related field.
• Three to five years of experience in medical staff affairs/credentialing, a credentials verification organization, or a related field.
• Certification or eligibility for certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS).

Responsibilities

• Coordinate and develop internal credentialing and primary-source verification processes to meet regulatory and accreditation requirements.
• Monitor process timeliness and provide feedback or reports to the appropriate manager.
• Audit credentialing database data-entry accuracy and provide feedback to internal and external customers.
• Investigate issues of concern and conduct follow-up; generate reports and present findings to the Manager of Medical Staff Affairs or Manager of Credentials Verification Organization.
• Serve as a subject matter expert for departments and facilities regarding initial and reappointment applications and privileging.
• Ensure assigned duties and responsibilities support compliance with Medical Staff Bylaws, Rules and Regulations, and/or daily CVO workflow.
• Work with the appropriate manager to develop policies and procedures that meet regulatory and accreditation requirements.
• Manage special projects as assigned.
• Assist Medical Director Department leadership in coordinating activities to fulfill departmental responsibilities and long-range plans and goals.
• Exercise discretion and independent judgment in evaluating courses of action related to primary-source verification and credentialing requirements.
• Investigate discrepancies in application and privileging data and formulate an appropriate course of action.
• Respond to provider, client, and customer inquiries within department timeframes while providing excellent customer service.
• Maintain statistical information related to departmental quality indicators.
• Orient and train new and current employees on departmental procedures, the credentialing database, and daily work.
• Maintain knowledge of relevant national accreditation agencies and federal and state regulations pertaining to credentialing.

Benefits

• Medical, dental, and vision insurance.
• Short-term and long-term disability insurance.
• Group term life insurance.
• Optional voluntary benefits.
• Employee Wellness rewards program with opportunities to earn gift cards and other rewards.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree