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Medical Staff Coordinator - Inpatient *Sign-on Bonus and Relocation*

Company: Providence Health & Services
Location: Santa Rosa
Posted on: August 5, 2022

Job Description:

Description We are looking for a Medical Staff Coordinator for the NCR Centralized Credentialing Department at Santa Rosa Memorial Hospital. Location: Santa Rosa, CA Work Schedule: Full time - 80 Biweekly Hours Shift: 8-hour, Days Job Summary: Responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical providers who provide patient care at Hospital. Responsible for ensuring providers are credentialed, appointed and privileged with health plans and hospital facilities. Maintains up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications. Responsible for preparation of medical staff meeting agendas, minutes, and follow-up correspondences. Works closely with contract credentials verification for appointment and reappointment of medical staff. Completes routine correspondences relative to verification of the medical staff status. Essential Functions:

  • Maintains knowledge of, and compliance with The Joint Commission standards pertaining to Medical Staff.
  • Maintains knowledge of, and compliance with, CMA Medical Staff Guidelines.
  • Maintains knowledge of, and compliance with, Medical Staff Bylaws, Rules and Regulations.
  • Coordinates and attends Medical Staff department/Service/Committee/general staff meetings.
  • Accurately completes credentialing, appointments and reappointment applications to be sent to payers and facilities on behalf of providers.
  • Tracks progress of outstanding applications and address issues as they arise.
  • Keeps current provider records electronically in credentialing software, electronic provider folders and in provider hard copy folders.
  • Tracks license and certification expirations, and DEA and professional liability expirations for all providers to ensure timely renewals.
  • Obtains needed documentation from providers, such as copies of state licenses, IRS documents, NPI Notification forms, DEA numbers, board certifications, malpractice certificate of insurance, etc.
  • Prepares professional communication to providers, payers and facilities.
  • Works closely with the external Medicare/Medicaid provider enrollment entities to discuss specific application/enrollment requirements including pre-requisites, forms required, form completion requirements, timelines, supporting document and regulations.
  • Maintains knowledge of current health plan and agency requirements for credentialing providers.
  • Audits health plan directories for current and accurate provider information.
  • Prepares follow-up correspondences with practitioners following credential actions.
  • Maintains confidentiality of Medical Staff credential files.
  • Completes payer credentialing process including requesting enrollment/contracting with health plans; completing the plans credentialing/enrollment application; submitting copies of licenses, insurance, and other documents; facilitating signing the contract; and any other steps that may be unique to the carrier.
  • Prepares calendar, maintains credits and prepares annual report.
  • Coordinates appointments/reappointments with contract credentialing organization.
  • Participates in budget process.
  • Collaborates with medical staff and Hospital in developing and achieving goals.
  • Makes sound decisions within range of expectation for the job; promotes positive guest/staff relations.
  • Creates an environment that enables the Hospital to fulfill its mission and meet/exceed its goals.
  • Demonstrates the ability to work on multiple tasks and set priorities.
  • Uses good judgment and discretion regarding confidentiality of sensitive issues.
  • Maintains knowledge of current and new developments in the field of medical staff services and credentialing through attendance at professional meetings and reading journals in the field.
  • Maintains and keeps current the physician contracts and agreements. (Timesheets, check requests).
  • Maintains physician agreements for contracted services, on-call, medical directorship and prepares check requests for the same on a monthly basis.
  • Performs other duties as assigned to support the department's objectives. Skills:
    • Ability to record meetings using shorthand or other note-taking skills.
    • Working knowledge of regulatory requirements (Title 22 and JC).
    • Knowledge of the development of and adherence to Governance bylaws, Department rules and regulations and Policies pertaining to medical staff, practitioner/provider and the organization.
    • Knowledge of 3rd party payer credentialing requirements.
    • Knowledge of Medicare/Medicaid provider enrollment.
    • Strong interpersonal skills.
    • Excellent verbal and written communication skills including customer service skills.
    • Expertise in using all Microsoft Office products including Excel, word processing, data base management and graphic presentations. Strong, accurate typing skills.
    • A team player, adaptive and collaborative while working across the organization.
    • Demonstrates good judgment and discretion regarding confidentiality of sensitive issues.
    • Ability to work and thrive under pressure while handling multiple priorities and meet deadlines.
    • Critical thinking skills.
    • Analytical Skills.
    • Ability to work strategically. Minimum Position Requirements: Education: Bachelor's Degree or any combination of education and experience that would provide the required knowledge, skills and abilities. Experience:
      • 2 years Credentialing experience in a hospital or physician environment.
      • Demonstrated experience with managed care, third party and government insurance provider enrollment. Preferred Position Qualifications: Licenses/Certifications:
        • Certified Provider Credentialing Specialist (CPCS).
        • Certified Professional Medical Services Management (CPMSM). About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Requsition ID: SR355064 Company: Providence Jobs Job Category: Medical Staff Support Services Job Function: Provider Services Schedule: Full time Shift: Day Career Track: Admin Support Department: 7820 NCR CNTR CREDENTIALING Address: CA Santa Rosa 1165 Montgomery Dr Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Keywords: Providence Health & Services, Santa Rosa , Medical Staff Coordinator - Inpatient *Sign-on Bonus and Relocation*, Healthcare , Santa Rosa, California

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