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Department: Administration (Credentialing)

Hours: Fulltime (1.0 FTE) – 7:00 a.m. to 3:30 p.m. M-F

Description:

Position Overview:

Processes and maintains medical staff credentialing files to ensure quality medical staff services and compliance with state, federal, and accreditation regulations. Coordinates the activities of the Medical Staff Bylaws and prepares full Medical Staff meetings. Provides executive administrative support to various medical staff department/services related to credentialing functions.

Essential Duties and Responsibilities:

• Carries out the Medical/Allied Health Professional Staff initial application process of a practitioner to provide care or services at Floyd County Medical Center (FCMC). Evaluates and conducts quality review of each new application file once received.
• Processes Medical Staff reappointments and ensures that providers are reappointed within a two-year period. Recognizes, investigates, and validates discrepancies and adverse information obtained from the application, primary source verifications, or other sources. Determines if providers meet the qualifications and criteria for reappointment and clinical privileges.
• Adds new Medical Staff providers to facility’s medical malpractice / professional liability insurance policy. Ensures coverage limits are appropriate and meet requirements.
• Monitors monthly expiration of medical and allied health professional staff state licenses, federal and state drug control registrations, professional liability insurance and board certifications. Collects renewed licenses, registrations, insurance, and certification documents in accordance with policy and updates database.
• Maintains an organized filing system for provider credential files and Medical Staff files.
• Ensures communication and coordination between the medical staff, administration, and other departments. Provides information to administration and the medical staff to meet the needs of the organization.
• Responsible for the coordination of medical staff department and committee meetings, including preparing materials and notices prior to meetings, documenting proceedings, and maintaining meeting minutes.
• Assists in developing policies and procedures pertaining to credentialing functions. Monitors state and federal regulations for changes that impact Medical Staff Bylaws and credentialing policies. Evaluate current policies and procedures for required updates and assist in creating new policies/forms as needed.
• Responds to reference requests and affiliation verifications from other health care institutions, managed care organizations regarding past and current medical/allied health professional staff.
• Maintains confidentiality of medical staff activities as they relate to peer review, and quality improvement.
• Participates in Centers for Medicare & Medicaid Services (CMS) and Iowa Department of Inspections and Appeals (DIA) surveys.
• Attends education seminars related to credentialing to maintain knowledge and compliance with standards and regulations.
• Manages providers who will be using DrFirst’s medication management and electronic prescribing services on InfinID web application.
• Assists Human Resources and Employee Health in obtaining needed pre-requisites for new Medical Staff such as background screen, drug screen, immunizations, and health assessment.
• Serves as back up to the Outpatient Specialty Clinic Coordinator and may assist as needed in working with locum tenens agencies to find and secure coverage for general surgeon. Serves as back up and assists as needed with obtaining accommodations for locum tenens surgeons and coordinating orientation for new surgeons.
• Assumes other duties and responsibilities that are related and appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all-inclusive.

Minimum Education and/or Experience Required:

• Associate’s degree preferred.
• Two to three years of previous experience in medical staff services/hospital credentialing highly preferred.

Additional Qualifications:

• Excellent oral and written communication skills required.
• Regular and Reliable attendance is expected.
• Must be able to read, speak, and write fluent English.
• Strong computer skills.
• Proficient in Microsoft Office.
• Strong analytical and critical thinking skills
• Integrity and ability to work independently. Initiative to take on tasks without being told.
• Extremely strong attention to detail.
• Adaptive to change, embraces change with optimism.
• Ability to prioritize assignments and manage time efficiently.
• Exceptional organization skills.
• Must be able to handle multiple duties simultaneously with a high degree of accuracy.
• Organizes and expresses ideas clearly, using appropriate documentation and communication methods.
• Responds to requests from medical staff and coworkers in a timely manner and communicates with them to ensure they are satisfied and that their needs are being met.
• Accepts constructive feedback in a positive manner.
• Identifies strengths and weaknesses, and targets areas for self-development. Participates in education opportunities and works toward developing new skills and enhancing existing skills.
• Manages time and prioritizes tasks to ensure that deadlines are met. Utilizes available resources when needed.
• Mature attitude and judgment; responsible; professional demeanor and appearance, patient and flexible.
• Ability to operate technologies and equipment associated with this position.
• Ability to work outside of regularly scheduled hours if needed.

Licensure/Certification Required:

• Member of the Iowa Association of Medical Staff Services
• Certified Provider Credentialing Specialist (CPCS) certification preferred.

Physical/Cognitive Requirements:

• Sit: Constant
• Stand: Occasionally
• Walk: Occasionally
• Lift:
  • 10 pounds Frequent
  • 25 pounds: Occasionally
  • 50 pounds*: Occasionally
  • 75 pounds*: Never
  • Greater than 100 pounds*: Never
• Carry:
  • 10 pounds: Frequent
  • 25 pounds: Occasionally
  • 50 pounds*: Occasionally
  • 75 pounds*: Never
  • Greater than 100 pounds*: Never
• Push/Pull:
  • 10 pounds: Frequent
  • 25 pounds: Occasionally
  • 50 pounds*: Occasionally
  • 75 pounds*: Never
  • Greater than 100 pounds*: Never
• Squat/Kneel/Crouch: Frequent
• Climb: Occasionally
• Balance: Never
• Twist: Occasionally
• Bend/Stoop: Occasionally
• Crawl: Never
• Grasp/Grip: Constant
• Talk: frequent
• Hear: Frequent
• See: Constant

• Anything greater than 50 pounds- assist of two or more, or mechanical lift are required.

Environmental Factors:

• May be exposed to communicable diseases due to working in a health care environment.
• Works in a well-illuminated climate-controlled environment.
• Work environment is comfortable, with minimal exposure to physical hazards.
• Moderate noise level when machines/equipment in use but typically quiet environment.

Organizational Relationships:

Reports to: Chief Ambulatory Officer

Employees supervised: None