Job Summary:
The Medical Staff Credentialing Specialist is responsible for ensuring that the company is fully compliant with all state and federal regulations at all times. As well as ensure that every staff member is legally licensed and/or credentialed and up to date with the latest medical policies and procedures.
Essential Functions, Duties and Responsibilities:
The following statements reflect the duties considered necessary to describe the essential functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in this position.
Primary Job Duties:
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Create and maintain licensing, credentials and insurance records.
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Conducts primary source verification, collects and validates documents to ensure accuracy of all credentialing elements.
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Assesses completeness of information and qualifications relative to credentialing standard and NYMC criteria.
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Conduct research on updated state and federal regulations and policies.
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Release information to requesting agencies and public inquiries when required by law.
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Help develop internal credential expiration dates and advise staff member of required renewal dates.
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Ensure that facility and staff members are maintaining compliance with regulatory and accrediting institutions.
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Responsible for maintaining copies of current licenses, certifications, and additional requirements.
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Assists in the development and implementation of process improvements for the credentialing process. Prepares reports and scoring required on day-to-day credentialing and issues as they arise.
Professional Expectations:
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Maintains professional affiliations and enhances professional growth and development by keeping abreast of the latest developments in appropriate area(s) and expertise through seminars, workshops, conferences, and continuing education, etc.
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Follows established department and organization policies, procedures, objectives, quality management, safety, environmental and infection control. Demonstrates understanding of behaviors consistence with the facilities mission, vision, goals, and values. Recognizes the importance of customer satisfaction. Develops appropriate behaviors and attitudes regarding exceeding customer expectations.
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Works to promote cooperative staff effort to provide and maintain high quality service to patients, physicians, and other hospital personnel to assure quality patient care. Courteously responds to inquiries.
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Maintains a neat, clen, and safe work environment.
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Performs other duties as requested and attends any medical staff or board meetings as needed.
Education and Experience Required:
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High School Diploma and a minimum of 2 years related experience preferred; or at least four years related experience and training, or an equivalent combination and work experience considered Certified Professional Credentialing Specialist (CPCS) certification preferred.
Working Conditions:
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? Normal office, team approach, multiple locations.
Mental Demands:
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? Must be able to work with strict deadlines and highly confidential information. Must be able to deal with sensitive issues and discussions with employees and physicians.
Physical demands:
Contacts:
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Physicians, patients/residents and their families, employees, volunteers, various regulatory agencies, and insurance companies.
