Credentialing Specialist Medical Staff Services

MAIN FUNCTION:

Under the direction of the Director of Medical Staff Services, the Credentialing Specialist is responsible for the entire initial credentialing and privileging process and reappointment process for all new medical staff and allied health professional applicants. This position collaborates with the Director of Medical Staff Services to ensure compliance with the Medical Staff Bylaws, Joint Commission standards, NCQA standards, and other regulatory requirements.

DUTIES AND RESPONSIBILITIES:

** 1. Responsible for initial credentialing of applicants to the Medical/Dental Staff and Allied Health Professional Staff for AOMC, SJH and office setting for employed practitioners.

** 2. Responsible to track reappointment dates and process reappointment applications in a timely manner for all practitioners in the Medical/Dental Staff and Allied Health Professional Staff for AOMC, SJH and office setting for employed practitioners.

3. Assists the Director of Medical Staff Services in tracking proctoring requirements for members of the Medical/AHP/Office staff.

** 4. Responsible for Locum Tenens applications processing and tracking dates for renewal and/or appointments and/or termination.

5. Issue temporary/emergency privileges, track dates for temporary/emergency privileges for renewal and/or appointments and/or termination.

** 6. Is responsible for completing the appointment/reappointment approval/disapproval letters after review by the Board of Directors & distribution of same, with privileges, to the practitioner and appropriate departments.

** 7. Attends departmental and committee meetings as assigned by the Director of Medical Staff Services and is responsible for transcribing minutes.

** 8. Responsible to track and maintain computerized credentialing database with Continuing Medical Education credits for the Medical Staff and Allied Health Professional staff as required for initial and reappointment credentialing.

9. In charge of creating monthly agenda for Medical/Board Credentials Committee and transcribing minutes of each. Responsible for follow-up of all items tabled at such Committee.

** 10. Is accountable for entering and maintaining call schedules in qliq.

11. Performs necessary queries and background checks required by DOH, CMS, JC, NCQA and other regulatory agencies.

12. Assists the Director of Medical Staff Services with assigned duties such as escorting practitioners on a tour of the hospital, working with HR to issue ID badges, working with Security to activate ID badges & provide access to appropriate areas of the hospital etc.

13. Is the Credential Office Administrator (COA) for Arnot Ogden Medical Center & St. Joseph’s Hospital to establish practitioners with access to DrFirst required for e-prescribing.

14. Accountable for generation, maintenance, and distribution of monthly Medical Staff Meeting calendar.

** 15. Responsible for distribution and tracking of Medical/AHP/Office dues.

** 16. Is responsible to enter and maintain the computerized credentialing database with recent and accurate credentials for tracking of license, DEA, malpractice insurance, mandatory in-services, infection control, histories and physicals, etc. for all members of the Medical/Dental, AHP & Office staffs to include scanning files into the credentialing database, when appropriate.

17. Accountable for running monthly practitioner exclusion checks through the computerized credentialing database and notifying the Director of Medical Staff Services with exclusions.

18. Attends Arnot Health inservice education programs as required.

19. Assists with the receipt of Medical Staff mail and distribution of same.

** 20. Responsible for physicians’ lounge inventory management including ordering supplies and maintaining the daily functions of the lounge.

21. Is responsible for Medical Staff Services office inventory management and ordering appropriate supplies to maintain the daily functions of the office.

** 22. Maintains the physicians' out-of-town file for coverage and is responsible for distribution/notification to appropriate departments in the Arnot Health System.

** 23. Assists in maintaining up-to-date privilege delineation files for the Operating Room and Nursing Administration at Arnot Ogden Medical Center and/or St. Joseph’s Hospital.

** 24. Accountable for responding to external hospital affiliation verifications in the time frame mandated by NYS DOH.

25. Assists the Department Chairs and Officers as requested.

26. Maintains confidentiality with regard to all aspects of the everyday functioning of the Department to include but not limited to records, files, meetings, personal and professional correspondence.

27. Is responsible for attending all annual mandatory educational programs as required by position.

28. Employee understands and demonstrates the importance of satisfying the needs of the customer/patient by interacting with him/her in a friendly and caring way, being attentive to the customer’s needs, both psychologically and physically, and by taking the initiative to maintain communication with the customer to provide a secure and pleasant experience with Arnot Health.

29. It is understood that this job description lists typical duties for the classification and is not considered inclusive of all duties which may be assigned.

EDUCATION:

Associate’s degree or higher education required. .

EXPERIENCE:

1-3 years of progressively increased experience in hospital credentialing preferred. Knowledge and experience using Microsoft Suite programs required.

CARDIOPULMONARY RESUSCITATION (CPR) REQUIREMENTS:

No CPR required.

PHYSICAL DEMANDS:

Typical office job.

EXPOSURE CATEGORY:

Category III. Tasks that involve no exposure to blood, body fluids, or tissues. Category I tasks are not a condition of employment.

** A.D.A Essential Functions