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HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field, you will find HSS an innovative, supportive and inclusive environment.

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Credentialing Coordinator

Enterprise Credentialing & Academic Promotions (ECAP)

Education Institute

Full-Time

Overview:

The Credentialing Coordinator, under supervision of Credentialing Manager plays a key role with development, planning and implementation of the credentialing/privileging process. The Credentialing Coordinator is responsible for maintaining the confidentiality of all Medical Staff related information, organizing and preparing for committee meetings, and ensuring compliance with the Medical Staff Bylaws, accrediting and regulatory agencies (i.e., Joint Commission, Centers for Medicare & Medicaid Services, NCQA) in regard to credentialing while developing and maintaining a working knowledge of the statutes and laws. In this role the ideal candidate will demonstrate exceptional customer service skills, attention to detail and organization, and excellent verbal and written communication skills.

Major Responsibilities include, but are not limited to :

• Initiates process for Physician/Allied Health/GME initial appointment applications and reappointment applications for hospital and regional sites
• Reviews and analyzes Physician/Allied Health/GME applications for initial appointment and reappointment and credentialing documents including clinical education/training, board certification and eligibility, licensure, accreditation, work history, liability insurance and malpractice claims history. Assesses completeness of information and qualifications relative to established standards. Identify and flag adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for Credentials Committee review
• Maintain applicant tracking system for follow-up of unanswered correspondence according to schedules designed to maintain departmental standards for application processing time
• Respond to all 2805-K verification query requests
• Tracks and maintains expiring licenses/registrations/health assessments for all credentialed providers and Focused Professional Practice Evaluations for all initial appointments
• Send monthly communications to credentialed providers and Department chiefs related to expiring licenses/registrations/health assessments
• Internally audit, organize and maintain provider files in accordance with established principles of legal documentation and confidentiality
• Assists in managing the flow of information between the ECAP team, Credentials and MEC Committee members, Medical Staff Leadership
• Assists in preparing files for payor delegated credentialing audits to ensure compliance.
• Perform other related ECAP Department assignments as required and provide backup coverage as needed
• Identify, develop, implement, and maintain credentialing/reappointment reports and or department workflow(s)
• Prepares and attends monthly Credentials Committee meetings, coordinates agenda, takes minutes and provides administrative support
• Prepares Credentials Report, coordinates agenda and supporting documents for Medical Board and Board of Trustees meetings
• Prepares data reports for various configurations of data such as provider profiles, pending provider list, and expired credentials
• Facilitates the ECAP Application Process Experience Survey
• Perform other related administrative ECAP Department assignments as required
  • Lead ECAP huddles
  • Coordinate On Boarding Task Force Meetings
  • Coordinate meetings with NYPH and Non-NYPH Program Coordinators/Administrators
  • Enrollment of 2 Factor Authentication via Imprivata for prescribers
  • EPIC approvals verify credentialed providers DEA in Cactus
  • EPIC/IT Ticket Submissions for GME InRotators and OnCalls

EDUCATION:

• Associates degree in a related field - Minimum Required
• Bachelors degree in a related field - Preferred
• CPCS - Preferred

PROFESSIONAL EXPERIENCE:

• Minimum of 1-3 years of experience in processing initial and reappointment applications with knowledge in Joint Commission, NCQA, & Centers for Medicare & Medicaid Services.

  Experience working on Cactus or MSOW database, and with excellent writing and verbal communication
• Prior experience in delegated credentialing (Preferred)
• Works well with high demand and strict deadlines (Preferred)

TECHNICAL SKILLS & ABILITIES

• Minimum Required
• Demonstrated ability to be a self-starter
• Project management skills
• Proficient in Microsoft Office programs such as Word, Excel and Powerpoint
• Excellent Organizational Skills
• Familiarity with EPIC clinical software solutions (Preferred)

INTERPERSONAL SKILLS & ABILITIES

• Minimum Required
• Demonstrates commitment to continual advancement of verbal and written communication skills
• Ability to exercise diplomacy and maintain positive working relationships with coworkers to include internal and external customers and administrative staff, thereby promoting good customer and departmental relationships
• Models high-level of Professionalism in all interactions
• Exhibits exceptional interpersonal/customer service skills and is able to cope with stress effectively
• High-level of Resiliency and Adaptability
• Demonstrated proficiency in setting priorities and organizing work to meet strict deadlines (Preferred)