To inspire health and healing by putting patients first - ALWAYS.
Position Summary
The Credentialing Medical Staff Coordinator is responsible for coordinating functions related to the Medical Staff Office.
Minimum Qualifications
Education
High School degree or equivalent required. Associate degree in administrative or medical office studies preferred.
Credentials
State Required: None GPRMC Required/Preferred: Certificate of Professional Medical Services Management preferred.
Physical Demands
1. Sit constantly. 2. Stand and/or walk frequently. 3. Lift up to 25# occasionally 4. Carry 25# up to 100 feet bilaterally and up to 10# unilaterally up to 100 feet. 5. Reach floor to overhead occasionally. 6. Bend, stoop, and crouch frequently. 7. Demonstrate visual acuity, hearing, manual dexterity, and eye hand coordination within normal limits for age and gender.
Essential Functions
Prepares and distributes agendas, packets and meeting minutes for Medical Staff Committees.
Works as a team with others in the Medical Staff Office to:
Work to credential and privilege Great Plains Health providers including locums/contracted providers.
Work with Medical Staff Leadership to investigate issues of concern and follow up with reports.
Monitor Medical Staff Bylaws and Rules and Regulations and recommend revisions.
Ensures Great Plains Health is compliant with standards applicable to Medical Staff members and Allied Health Professionals.
Ensure activities of the Medical Staff Office complies with applicable agencies including CIHQ, State of Nebraska and the Centers for Medicare/Medicaid Services.
Conduct affiliation verifications for other facilities and works to ensure responses are accurate and up to date.
Monitors expirables of the medical staff including license, certifications and insurance and works with providers and clinic managers and locum representatives to gather information and upload that information in the credentialing tracking system (currently MD-Staff).
Conducts audits of credentials files and provides a regular report of findings and corrections made.
Works with Payer Enrollment Coordinator for credentialing requests.
Credentials and builds order only providers in EPIC and all other related duties with these processes as a backup. Works with Registration/Patient Access to ensure processes are followed and demographics are entered accurately.
Coordinates with malpractice insurance carriers to ensure providers have appropriate and timely coverage as required by the medical staff credentials policy and manages payments for premiums, NE Excess Fund and Tail Coverage.
Communicates practitioner information required to obtain computer access in all systems to GPH IT staff in a timely manner.
Accurately prepares credentialing letters and documentation sent to practitioners on behalf of the board of directors and prepares Board of Director Credentials report.
Responsible for creating and updating delineation of privileges for all categories and specialties of the Medical Staff.
Ensures contracts are in place, and appropriate, for credentialing by proxy for telehealth providers.
Completes all required reporting from the Medical Staff Office including Livanta/Kepro and CMS reports.
Coordinates all activities of the Lincoln County Medical Society, on behalf of the Medical Executive Committee.
Works with Sr. Director of Physician Services to support and assist Physician Services initiatives and processes.