Medical Staff Coordinator - Centralized Credentialing
Company: Providence Health & Services
Location: Santa Rosa
Posted on: August 5, 2022
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
- Maintains knowledge of, and compliance with The Joint
Commission standards pertaining to Medical Staff.
- Maintains knowledge of, and compliance with, CMA Medical Staff
- 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
- Tracks license and certification expirations, and DEA and
professional liability expirations for all providers to ensure
- Obtains needed documentation from providers, such as copies of
state licenses, IRS documents, NPI Notification forms, DEA numbers,
board certifications, malpractice certificate of insurance,
- Prepares professional communication to providers, payers and
- 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
- Maintains knowledge of current health plan and agency
requirements for credentialing providers.
- Audits health plan directories for current and accurate
- Prepares follow-up correspondences with practitioners following
- Maintains confidentiality of Medical Staff credential
- 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
- Prepares calendar, maintains credits and prepares annual
- Coordinates appointments/reappointments with contract
- Participates in budget process.
- Collaborates with medical staff and Hospital in developing and
- 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
- Uses good judgment and discretion regarding confidentiality of
- 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
- 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
- Ability to record meetings using shorthand or other note-taking
- Working knowledge of regulatory requirements (Title 22 and
- 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
- 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
- 2 years Credentialing experience in a hospital or physician
- Demonstrated experience with managed care, third party and
government insurance provider enrollment. Preferred Position
- Certified Provider Credentialing Specialist (CPCS).
- Certified Professional Medical Services Management (CPMSM).
Providence St. Joseph Health (Providence) has worked for decades to
improve health and quality of life in California's North Bay
region, starting in Sonoma County, where the Sisters of St. Joseph
of Orange opened the doors of Santa Rosa Memorial Hospital in 1950.
Today, we continue the mission begun by the Sisters to those we
serve through an integrated spectrum of primary, urgent, acute,
outpatient, palliative care and regional referral services. Sonoma
County facilities aligned with Providence include the 278-bed Santa
Rosa Memorial Hospital, the region's only Level II trauma center.
In addition, the 80-bed Petaluma Valley Hospital and 43-bed
Healdsburg Hospital are secular (non-religious) affiliates of
Providence. Our services also encompass three Urgent Care centers,
Hospice of Petaluma, Memorial Hospice and North County Hospice, the
Annadel Medical Group doing business as St. Joseph Health Medical
Group, as well as the St. Joseph Home Care Network (post-acute care
services). We act as a regional referral hub for outlying
hospitals, while also providing outpatient behavioral health care,
education to promote health and prevent chronic disease,
rehabilitation, oral health care, community benefit programs, and
more, all fostering health and quality of life throughout the area.
Providence provides equal employment opportunities (EEO) to all
employees and applicants for employment without regard to race,
color, religion, sex, national origin, age, disability or genetics.
In addition to federal law requirements, Providence complies with
applicable state and local laws governing nondiscrimination in
employment in every location in which the company has facilities.
This policy applies to all terms and conditions of employment,
including recruiting, hiring, placement, promotion, termination,
layoff, recall, transfer, leaves of absence, compensation and
training. Positions specified as "on call/per diem" refers to
employment consisting of shifts scheduled on as "as needed basis"
to fill in for staff vacancies. Company: Sonoma County Entities
Category: Administrative ( Non-clinical) Req ID: R355064
Keywords: Providence Health & Services, Santa Rosa , Medical Staff Coordinator - Centralized Credentialing, Healthcare , Santa Rosa, California
Didn't find what you're looking for? Search again!