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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