We are Multi-specialty, Multi-State Practice looking for a Credentialing specialist to perform credentialing activities such as provider enrollment, accreditation, membership or facility privileges not requiring constant supervision of technical details. Must perform related duties as assigned. Must be committed, self-motivated, and dedicated to accurate and timely submission/acquisition of data for our practitioners to operate without interruption to productivity. This position is remote full time.
The Credential specialist functions as a liaison between the medical staff, allied healthcare professionals, legal counsel, and administration with regard to credentialing processes, interpretation and application of Joint Commission standards, medical/legal issues, state and federal guidelines, and regulatory agency guidelines as they relate to credentialing, peer review and compliance issues.
Cura Telehealth and Wellness is an Equal Opportunity/Affirmative Action Employer
The Medical Staff Specialist Senior responsibilities include, but are not limited to, the following:
- Develops, manages, and administers medical staff and allied health professional credentialing processes for provider enrollment and hospital privileges.
- Collaborates with department chairs and chair of Credentials Committee to review applicants and privileges requested
- Collaborates with department chairs and/or clinical program medical directors to develop privilege forms for all specialties across the system
- Supports Director of Physician relations in knowledge of credentialing applications, Medical Staff Bylaws and medical staff governance
- Ensures compliance with Joint Commission standards, federal and state guidelines, and regulatory agency guidelines
- Develops and administers Physician Orientation program for newly appointed Medical Staff Appointees
- Assists with developing and ensuring compliance with the medical staff bylaws, rules and regulations, and hospital policies
- Reviews and screens highly sensitive credentialing documents, and provides summaries and advice
- Verifies applicant information and ensures that the application process is completed in a timely manner.
- Coordinates and documents medical staff ad hoc investigation committee activities, and assists in coordination of fair hearing procedures in conjunction with INTEGRIS Legal Services
- Organizes and prepares meeting agendas and documents to be presented for Credentialing Committee and/or, Medical Executive Committee., and Medical Quality Committee.
- Provides appropriate reporting of minutes for Medical Staff Committees to the Board of Directors.
- Supports the Manager/Director in medical staff functions of credentialing, OPPE/FPPE, Bylaws and Rules and Regulations.
- Maintains provider privileges and serves as a resource for verification of privileges and affiliation.
- Maintains accurate and timely rosters of credentialed medical staff with board approval dates and resignation dates.
Reports to the Manager or Director as assigned
Normal office environment.
All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
- Bachelors degree preferred
- Certification of CPCS and/or CPMSM or 5 years of experience as a medical staff coordinator or provider enrollment specialist
- Knowledge of medical terminology
- Knowledge of Joint Commission and NCQA standards and medical/legal requirements related to credentialing, peer review and compliance
- Must be able to communicate effectively in English (Verbal/Written)
Job Type: Full-time
Pay: $19.42 - $23.39 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Life insurance
- Vision insurance
Schedule:
Ability to Commute:
- Tulsa, OK 74137 (Required)
Ability to Relocate:
- Tulsa, OK 74137: Relocate before starting work (Required)
Work Location: In person