Medical Staff Professional - Credentialing & Privileging

1855 Powder Mill Rd•York, PA

2d•Hybrid

About The Position

At OSS Health, our mission is to continually strive to be the healthcare leader in quality, innovation and value. We make every effort to understand and exceed the expectations and needs of our patients. We are committed to providing an environment that is safe, respectful, and dignified at all times. Joining OSS Health means joining a culture of excellence and teamwork, with a strong focus on employee development and community support. OSS Health offers a great work environment, professional development opportunities, meaningful careers, and competitive compensation. Are you ready to provide a 5-star “OSSOME” experience? Apply today! JOB SUMMARY: Under direct supervision from the Medical Staff Services Manager, the Medical Staff Professional is responsible for assisting in credentialing and privileging new and established healthcare providers. The incumbent will assist in the maintenance of information to include primary source verification, verification follow-up, data collection, data entry, tracking and updating expiring credentials, and document review. The incumbent will also assist with the FPPE and OPPE data collection, provider enrollment, insurance follow-up and claims denials related to enrollment. SCHEDULE: 8:00am - 5:00pm Monday - Friday, with a 30 minute lunch. Hybrid flexibility allowed but with expectation to have presence in office for team meetings, etc.

Requirements

High school diploma or its equivalent required.
A minimum of two (2) years of experience in the Medical Staff Services profession or two (2) years of experience working in the medial healthcare field preferred.
Certified Provider Credentialing Specialist (CPCS) certification or the ability to obtain CPCS certification within two years of hire.
Basic knowledge of medical terminology is preferred.
Must be proficient with computers, including Microsoft Word and Excel; MD-Staff credentialing software experience preferred.
Must possess excellent interpersonal skills.
Must possess strong attention to detail.
Most possess critical thinking and problem-solving skills.
Must be able to work with minimal supervision and be able to utilize effective time management principles.
Must have the ability to handle multiple tasks simultaneously; must have the ability to work under short deadlines.
Demonstrated respect for confidentiality.

Responsibilities

Evaluate applications to determine applicants’ initial eligibility for membership/participation.
Review applications and supporting documents for completeness; determine eligibility based upon approved criteria.
Serve as main point of contact for assigned practitioners during application process, providing timely updates and additional information as requested.
Compile, evaluate, and present the practitioner-specific data collected for review by one or more decision-making bodies.
Perform initial or reappointment/re-credentialing for eligible practitioners.
Process requests for privileges.
Conduct, participate in, and maintain credentialing verifications.
Conduct Primary Source Verifications.
Assist in the management of the Credentialing or Privileging Process; apply defined credentialing processes to all practitioners/providers, evaluate requests, coordinate the contract processes and underwriting of practitioners
Maintain Current Clinical Competency Evaluations and Peer Review, to include FPPE/OPPE:
Maintain compliance with Accreditation and Regulatory Standards; compile sanctions and complaints, participate in surveys and audits of regulatory or accreditation agencies
Ensure compliance with State and Federal accreditation standards and regulatory requirements
Follow established Provider Enrollment processes
Assist with departmental operations by maintaining credentialing database, assisting with audits and assessments, and other duties as assigned.