You will be required to maintain knowledge of current hospital policies and bylaws as well as staffing procedures and policies. Responsibilities will involve verifying medical staff credentials, making sure physicians and allied health professionals are up to date on their certifications, and ensuring that all facilities meet accreditation standards. Maintain up to date data for each provider in insurance credentialing databases and online systems; ensure timely enrollment of providers and facilities in health plans and licensure of facilities. Coordination of medical staff activities that include but are not limited to secretarial duties such as taking minutes at medical staff meetings. Act as a liaison between medical staff, administration, Revenue Cycle, and related health agencies. Maintain current medical staff/dept/committee roster and any other roster required.
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Coordinates provider applications; monitors applications and follows-up as needed.
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Maintains records and roster of all approved and pending providers and facilities.
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Coordinates with Human Resources to ensure seamless provider onboarding and billing of provided services.
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Maintains knowledge of current health plan contracts and agency requirements for credentialing providers. Coordinates enrollment of facilities and providers as required.
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Sets up and maintains current provider information in online credentialing database, NLHD systems and contracted vendors databases.
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Assist Medical Staff Services and Medical Chief Officer with meetings, doocumentations, presentations, and other functions.
Values
i - Innovation
"Think Forward" "Set Out-Of-The Box Goals" "Exploring new possibilities" I am the change agent that advocates for our customers. I think outside of the box to create Exceptional experiences that set us apart. I look for solutions and think of new ways to solve problems, even if it is outside of my department.
C - Compassion
"Demonstrate genuine concern" "Display a Selfless attitude" I show kindness in every interaction. I strive to build trust with our co-workers and customers. I will communicate with our co-workers and customers in a way they understand. I will make time to address our co-workers and customers' needs.
A - Accountability
"Show integrity" "Accept Ownership & Responsibility" I will demonstrate integrity by doing the right thing, being honest and having strong moral principles. When mistakes occur, I take the necessary steps to correct them, without dismissing patient concerns and follow through until resolution. I fully document actions taken to ensure continuity of care. I communicate expectations and follow up within defined time frames and provide updates as I understand them for my customers and teammates.
R - Respect
"We value diversity" "Respect is earned" I treat all people with dignity and respect, regardless of their beliefs. I do not use negative/derogatory language. I accept constructive feedback and suggestions for the greater good.
E - Empowerment
"Share Knowledge" "Take Action" I will share knowledge to empower others and encourage them to make informed decisions. I encourage others to reach their full potential. I will encourage trying new things, diverse ideas, and learning from our mistakes. I have the freedom to do what is right for our customers.
Organization Expectations
Communication
The process of sending and receiving messages with words, verbally, written or in sign language.
Customer Focus
Identifying and responding to current and future patient and other customers’ needs; providing excellent service to internal and external patients and other customers.
Initiative
Identifying and dealing with issues proactively and persistently; seizing opportunities that arise.
Self-Development
Lifelong, voluntary, and self-motivated learning.
Teamwork
Effectively work and complete assignments in group settings. Works independently and cooperatively with others to achieve common goals.
Experience
Two years of relevant credentialing and insurance credentialing experience preferred.
Education
High school diploma or equivalent.
Associate degree preferred.
Licensure/Certification- Current
Certified Provider Credentialing Specialist (CPCS)
If you are a current employee or have previously worked for Nor-Lea Hospital District, please contact the Human Resources Department at [email protected] for your correct username and password.
