Medical Staff/Credentialing Specialist - FT - McAllen

UHS•McAllen, TX

8d•Onsite

About The Position

Within the Medical Staff Services and Peer Review Department and under limited supervision, the Medical Staff Coordinator serves as an essential link and resource between the system director, system manager, senior management and medical staff to coordinate the operational processes and ongoing credentialing, privileging, and medical staff governance functions of the Organized Medical Staff. Responsible for review, analysis and follow up of credentialing and privileging applications, maintaining strict confidentiality, and ensuring compliance with organizational policies and accrediting and regulatory agencies.

Requirements

Minimum of three years experience in Medical Staff Services and credentialing and privileging in a hospital setting.
Must possess and maintain a valid NAMSS CPCS certification or meet the eligibility requirements to obtain it within one year of employment.

Nice To Haves

Associates or Bachelor’s Degree preferred.

Responsibilities

Assists in the management of the medical staff support function for the Medical Staff Organization as outlined in the Medical Staff Bylaws.
Coordinates and processes credentialing and privileging applications; primary source verifications; performs review and analysis, identification and follow up of "red flag" items; prepares files for review and recommendation by the MSS department leadership and medical staff.
Coordinates credentialing end-of-committee process to ensure notification of providers, departments, database and privileging updates; and completion of files as appropriate.
Schedules, coordinates, prepares agenda, takes minutes, provides follow up for medical staff committees outlined in the Medical Staff Bylaws.
Prepares summary reports of credentialing/privileging recommendations and ensures flow of information and action items for medical staff committees outlined in the Medical Staff Bylaws, policies, and procedures.
Assists in coordination, tracking, and monitoring of the FPPE process ensuring compliance with regulatory standards and policies.
Under the direction of System Director and Manager interprets Federal, State, local, and government/insurance agency regulations and guidelines, Medical Staff Bylaws, rules and regulations, policies and procedures; advises providers, management, and administrators on compliance issues as appropriate.
Generates queries and reports from credentialing and privileging database.
Assists with clinical privilege development and maintenance of the privilege database.
Performs miscellaneous job-related duties as assigned.