Credentialing Specialist, Marin General Hospital, Greenbrae, CA
Posted on May 29th, 2019
CREDENTIALING SPECIALIST - High paying, exciting and rewarding opportunity in beautiful Marin County California.
ABOUT MARIN GENERAL HOSPITAL:
Come and be a part of our healing team at the award-winning Marin General Hospital! Ranked in the top 3% of general hospitals in the country, we have made great strides since returning to our roots as an independent hospital. Our Joint-Commission accredited hospital has won numerous awards and certifications in delivering best-in-class health care in the San Francisco Bay Area.
Marin General Hospital offers a generous suite of employee benefits, which includes a comprehensive and rich health benefits program (medical, dental, vision and prescription plans). Our robust Wellness @ Work program (e.g. onsite health & fitness classes, discounts, etc) also promotes a healthier lifestyle for employees and to support you on your Healthy Healer journey. Other benefits include, but are not limited to, a 403(b) contribution plan and company-funded retirement plan, life insurance, vacation, holiday and sick leave, which you will start accruing immediately. Our benefits are highly competitive and considered to be one of the best in the Bay Area! Find your healing place at Marin General Hospital.
JOB SUMMARY:
Under general supervision, supports all aspects of the credentialing and privileging process for Medical Staff members and Allied Health Professionals at Marin General Hospital (MGH). May assist in the processing of urgent applications or temporary privileges. In addition, performs a full range of routine clerical and administrative specialist tasks, which may include day-to-day operations needs, interacting with hospital personnel and physicians, receiving and processing mail, and answering the telephone.
JOB SPECIFICATIONS:
A. EDUCATION
High school diploma, GED, or equivalent required. Completion of two or more years of college or business school is strongly preferred, and may substitute for the required experience below on a year-for-year basis. National Association of Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) certification may substitute for 1 of the 2 years of college, and is highly desirable.
B. EXPERIENCE
A minimum of three years of progressively-responsible secretarial or administrative assistant experience, preferably in a credentialing verification organization, or an acute hospital health care setting, which included significant experience with computer software, preferably in a Windows environment and at an intermediate to advanced skill level, with such applications as word processing, spreadsheets, tables, graphs, and database management.
C. PREREQUISITE SKILLS:
1. Knowledge of Joint Commission accreditation principles, processes, procedures, and documentation applicable to medical provider credentialing
2. Working knowledge of clinical and/or hospital operations and procedures
3. Ability to utilize proprietary databases such as MIDAS or Echo, including data entry and report generation skills
4. Basic knowledge of provider credentialing accreditation regulations, guidelines, and standards
5. Accurate typing at 45 wpm
6. Knowledge of Microsoft Office suite of programs, including Outlook, Word and Excel
7. Knowledge of Internet resources and regulatory agencies such as Medical Board of California, Drug Enforcement Administration (DEA), National Practitioner Data Bank, and Office of Inspector General (OIG)
8. Ability to use independent judgment
9. Demonstrated analytical skills to handle non-routine, moderately complex administrative duties, and confidential information
10. Demonstrated experience in general office procedures and ability to handle everyday administrative duties in a professional and efficient manner
11. Demonstrated excellent verbal and written communication skills
12. Demonstrated interpersonal skills necessary to work collaboratively, effectively and courteously with a diverse group of internal and external callers and visitors such as physicians
13. Ability to coordinate multiple priorities, problem solve, and meet deadlines with minimal supervision
14. Basic knowledge of medical terminology
15. Ability to coordinate demands and arrange project schedules accordingly
16. Ability to operate standard business machines, such as personal computer, calculator, copier, scanner, typewriter and facsimile
LICENSE/REGISTRATION/CERTIFICATION:
None required
DUTIES AND RESPONSIBILITIES:
1. Processes Medical Staff and Allied Health Professional credentialing applications for completeness, accuracy, and compliance with federal, state, local and MGH regulations, guidelines, policies, and standards
2. Performs external research and conducts verification of all applicant licensure, education and training, relevant affiliations; assesses compliance with criteria, and monitors eligibility and Certification
3. Initiates and performs document collection and review for the appointment and reappointment processes of providers, ensuring accuracy, timeliness, and completeness of all documentation
4. Serves as initial point of contact to the hospital and medical staff on day-to-day issues concerning current members’ applications
5. Continually monitors expirations of licensure, DEA certificate, Professional Liability Coverage, Board Certification, other appropriate certificates or licenses, and ensures that updated documentation is collected and/or electronically verified prior to expiration
6. Maintains confidential files and documentation of health care professionals seeking / holding medical staff membership and Allied Health Professional status
7. Understands federal, state, local, and government/insurance agency regulations and guidelines, as well as Medical Staff Bylaws, Rules and Regulations and Policies and Procedures for the hospital and medical staff
8. Ensures that data on all practitioners in the Medical Staff database and the various credentials filing systems is accurate, and validates the integrity of data
9. Interfaces with providers, hospital departments, and all related external health care agencies on day-to-day credentialing and privileging issues
10. Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; compiles information for Department Chairs as appropriate
11. Performs Internet, agency, and/or internal research as appropriate; analyzes and prepares findings and submits to Director and/or medical staff leaders
12. Directs complex, urgent, or sensitive issues to supervisor
13. Appropriately maintains and efficiently handles confidential information such as credentialing files, and physician-specific aggregate patient data
Send resumes directly to natalie.callahan-worthington@maringeneral.org or apply on our company website: https://www.maringeneral.org/about-us/career-opportunities - job number 9434-EN115