Description

COVENANT HEALTHCARE

US:MI:SAGINAW

8:00 AM - 4:30 PM, MONDAY - FRIDAY

FULL TIME BENEFITED

Summary:
The Credentialing Specialist demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant and the commitment to Extraordinary Care for Every Generation. This individual is responsible for providing technical expertise for initiation and follow-through of the application process for appointment and reappointment of Medical Staff and Allied Health Professionals requiring a thorough understanding of the credentialing process; maintains accurate and complete data in MSO for Windows software system, and generates queries and reports; maintains organization and confidentiality of Medical Staff documents, maintains knowledge of all Medical Staff functions, including JCAHO standards, and state, federal and legal requirements.

Responsibilities:
MEDICAL & ALLIED HEALTH PROFESSIONAL INITIAL CREDENTIALING
Responds to requests for appointment by sending applications and appropriate clinical privileges/service authority forms.
Responsible for accurate primary source verification of credentials, including all licenses, education, hospital and employement affiliations, references, criminal background check, federal sanction, National Practitioner Data Bank, American Medical Association, and ECFMG.
Monitors status of applications by responding to provider and primary sources in order to obtain information in a timely manner.
Assists section chiefs and department chairs in the application review process. Has knolwedge of Medical Staff Bylaws and credenitaling policies in order to direct them appropriately.
Prepares and transmits application packets to Credentials Committee members for their review.
Maintains the highest level of confidentiality with credenitaling files.
Reviews negative findings with Medical Staff Services manager.
Assists other hospitals/organizations in their credentialing process by responding to appropriate requests for information.
Assures compliance with HFAP standards, state and federal requirements.
Contribues to the organizations financial goals by enusring timely processing of appoinment applications.
MEDICAL & ALLIED HEALTH PROFESSIONAL REAPPOINTMENTS
Responsible for initiating reappointment process for each Medical Staff /Allied Health Professional member every two (2) years as per HFAP standards.
Responsible for accurate primary source verification of credentials, including all licenses, criminal background check, federal sanctions, National Practitioner Data Bank, and American Medical Association.
Monitors status of applications by responding to provider and primary sources in order to obtain information in a timely manner.
Obtains statistics on volumes and quality of care provided by Medical Staff/Allied Health Professional members.
Prescreens reappointment forms and delineation of privileges prior to presentation to department chair to ensure they have all the necessary inforamtion to make recommendations.
Reviews negative findings with Medical Staff Services manager.
Assists section chiefs and department chairs in the application review process. Has knolwedge of Medical Staff bylaws and credenitaling policies in order to director them appropriately.
Maintains confidential reappointment files.
Assures compliance with HFAP standards, state and federal requirements during the reapointment process.
CREDENTIALING LOCUM TENEN PRACTITIONERS
Responsible for initiating the locum tenens credentialing process when notified by the deparement head.
Works closely with the department head and the staffing agency to ensure timely completion of credentialing process.
Respnsible for having knowledge and understanding Medical Staff Bylaws and Credentialing policies related to the use of Locum Tenens pracitioners in the organization.
Responsible for accurate primary source verification of credentials, including all licenses, criminal background check, federal sanctions, National Practitioner Data Bank, and American Medical Association.
Monitors status of applications by responding to provider and primary sources in order to obtain information in a timely manner.
Prescreens locum tenens credentialing delineation of privileges prior to presentation to VPMA and Chief of Staff. Ensures that all information is present in order for the VPMA and Chief of Staff to make a recommendation.
Reviews negative findings with Medical Staff Services Manager.
Maintains confidential locum tenens files.
Assures compliance with HFAP standards, state and federal requirements during the credentialing process.
Contribues to the organizations financial goals by enusring timely processing of locum tenens applications.
OTHER DUTIES
Responsible for accuracy of provider demographics that are inputted into the credentialing software.
Responsible for understanding the Medical Staff Chapter HFAP standards and applying them to the credentialing process.
Responsible for staying current on credentialing industry best practices.
Networking with local and state wide colleagues is expected.

Other information:
EDUCATION/EXPERIENCE
Associate's Degree in Health Services Administration or Business required. Bachelor's Degree preferred. Current certification as a Certified Provider Credentialing Specialist preferred, or test at first opportunity.
Hospital-based medical staff office experience preferred, knowledge of hospital-based work flows and departments or physician office based experience.

KNOWLEDGE/SKILLS/ABILITIES
Computer and word processing ability including Microsoft Word and Excel, typing, ability to communicate well with others, proficiency in listening, writing and speaking.
Excellent written communication skills for constructing minutes and correspondence, and excellent verbal skills for communicating individually and in group meetings.
Excellent word processing and computer skills.
Incorporates continuous quality improvement principles into daily activities.
Strong interpersonal, diplomatic and organizational skills
Demonstrates ability to maintain information in a confidential manner
Customer Service focused in all daily activities
Demonstrates ability to make sound independent decisions within boundaries of polices and procedures

PHYSICAL LEVEL I

NOTICE REGARDING LATEX SENSITIVITY IN APPLICANTS FOR EMPLOYMENT.

IT HAS BEEN DETERMINED THAT COVENANT HEALTHCARE CANNOT PROVIDE A LATEX SAFE OR LATEX FREE WORK ENVIRONMENT AT ANY OF ITS FACILITIES. UNFORTUNATELY, THAT MEANS THAT ANY INDIVIDUAL, INCLUDING AN APPLICANT OR AN EMPLOYEE, IS LIKELY TO BE EXPOSED TO LATEX WHILE ON COVENANT S PREMISES. THEREFORE, LATEX TOLERANCE IS CONSIDERED TO BE AN ESSENTIAL FUNCTION FOR ANY POSITION WITH COVENANT.

Covenant HealthCare is an equal opportunity employer.