Credentialing coordinator

Responsibilities include accreditation compliance, credentialing, privileging, Medical Staff committee support, and policy and procedure compliance.

This position monitors the latest regulatory standards and ensures compliance. Responsibilities have a direct and significant impact on hospital accreditation, performance improvement, and patient care.

This position interacts professionally with medical staff leadership and facilitates communication between medical staff, hospital staff, clinical directors, and administration.

Hospital departments rely on this position to assist in ensuring that the medical staff complies with various policies and regulatory standards.

Essential Functions

• Coordinates the daily credentialing and privileging functions of the medical staff services department.
• Generates new approaches to improve quality and cost-effectiveness of the department.
• Utilizes a variety of database and word processing software and equipment; keeps abreast of technological trends; develops guidelines in the use of these resources.
• Assists with development of policies and procedures related to the functions of the department.
• Manages documentation systems for medical staff files.
• Coordinates the functions related to the credentialing process for the Allied Health Professionals and Medical Staff to include appointments, reappointments, and privilege modifications.
• Reviews and analyzes credential applications and verifications for applicant qualifications; prepares reports for presentation to the required Medical Staff and administrative bodies.
• Assists in maintaining privileging criteria appropriate to current trends in training and technology.
• Organizes Medical Staff department and committee meetings and assures accurate documentation of the activities and actions of those meetings.

Initiates necessary steps to follow-up on actions taken in those meetings.

• May act as liaison between the Medical staff and Administration to assure timely communication of Medical Staff and hospital issues.
• Originates verbal and written communications with Medical Staff, leadership, regulatory bodies, and other entities as required.
• Attends and participates in meetings to assure efficient and effective credentials processes are maintained.
• Develops and maintains privilege delineation forms through ongoing review of criteria and procedures with current standards and practices;

creates and develops other administrative forms needed.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.

Duties, responsibilities and activities may change at any time with or without notice.

Minimum Education / Certifications

Associates degree preferred or equivalent education / experience.

Minimum Work Experience

Minimum of two years of experience in one of the following venues : hospitals, managed care, credentialing verification organizations, or ambulatory care.

• Three years in medical staff services is preferred.
• Experience in working with governance processes is essential.
• Must have strong computer, communication and writing skills with knowledge of medical terminology.
• Working knowledge of regulatory and accreditation requirements
• Ability to communicate effectively in both verbal and written form with staff at all levels
• Strong familiarity with regulatory and accreditation requirements
• Demonstrated skills in strategic planning, evaluating programs and implementing solutions

Functional / Technical Skills Requirements :

Comprehensive understanding of operational health care delivery systems and the current health care landscape. Skills and experience with the operational aspects of health care technology deployment.

Familiarity and comfort with technology-based operational improvement.

Communications : Excellent written and verbal communications skills. Ability to take abstract, complex and / or technical information and break it down for a variety of audiences in a way that is meaningful for them.

PI254940591

Last updated : 2024-11-14