Presbyterian Healthcare Services MEDICAL STAFF CREDENTIALING COORDINATOR in Santa Fe, New Mexico
Type of Opportunity: Full Time
Work Schedule: Days
Supports the Medical and Allied Health Staff credentialing/primary sourcing verification program by coordinating and developing internal processes in order to meet requirements of federal and state regulatory and national accreditation agencies. Monitors timeliness of processes and provides feedback and/or reports to the appropriate manager. Audits accuracy of data entry in the credentialing database and provides feedback to appropriate internal and external customers. This position requires in-depth knowledge of medical and allied health staff credentialing processes and requirements. Investigates issues of concern and conducts follow-up as needed, generates reports and presents findings to the Manager of Medical Staff Affairs (MSA) or Manager of Credentials Verification Organization (CVO). Serves as a subject matter expert to other PHS departments and facilities as it relates to the processing of initial and/or reappointment applications and/or privileging. Responsible for assigned duties and responsibilities to ensure compliance with the Medical Staff Bylaws, Rules/Regulations and/ or the daily work flow of the CVO. Works with the appropriate manager in the development of policies and procedures to meet regulatory and accreditation requirements. Manages special projects as assigned.
*Assists the Medical Director Department leadership in managing activities to ensure a coordinated effort to fulfill departmental responsibilities within its long-range plans and goals
*Exercises discretion and independent judgment involving the comparison and the evaluation of possible courses of action related to meeting primary source verification and credentialing requirements. Acts or reaches decisions independently after the various possibilities have been considered.
- Investigates discrepancies in data submittal related to applications and privileging and formulates appropriate course of action.
*Provides excellent customer service by responding to provider, client, and customer inquiries within specified timeframes, as required by the department
*Maintains statistical information relative to the departments quality indicators
*Responsible for orientation/training of new and current employees as it relates to departmental procedures, credentialing database, and daily work
*Serves as a subject matter expert on appropriate national accreditation agencies and federal/state regulations pertaining to required credentialing processes
*Maintains knowledge base of appropriate national accrediting agencies
Associates Degree/Diploma in medical staff services studies, or a related field preferred. Three to five years experience in medical staff affairs/credentialing, credentials verification organization, or related field preferred. Public relation skills required in order to be effective and behave in a professional manner when dealing with practitioners and customers. Requires excellent time management and organizational skills in order to handle multiple projects simultaneously. Certification or eligibility for certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred.
Essential: * High School Diploma or GED
Competencies and skills:
SKILL-Ability to effectively interact with customers to understand their needs and explain data
SKILL-Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff using strong dialogue and customer service competencies.
Benefits are effective day-one (for .45 FTE and above) and include:
Full medical, dental and vision insurance
Flexible spending accounts (FSAs)
Free wellness programs
Paid time off (PTO)
Retirement plans, including matching employer contributions
Continuing education and career development opportunities
Life insurance and short/long term disability programs
Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-speciality medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.
Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.
Presbyterian Santa Fe exists to improve the health of patients, members and the communities we serve in Northern New Mexico. Through our commitment to these communities, we are expanding choice, enhancing quality and elevating the patient experience.
About New Mexico
New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great.
Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.
New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Requisition ID: 2020-18041
Street: 4801 Beckner Road
JobTitle: MEDICAL STAFF CREDENTIALING COORDINATOR