Coordinate system-wide credentialing and privileging for Essentia Health's providers and/or facilities. Additional responsibilities may include: coordinate and staff various committees (Credentials, Medical Executive Committee, Board, Medical Staff); provide guidance and support to physician and non-physician leadership; coordinate physician/credentialed provider expirables; audit physician/credentialed provider/facility paperwork for accuracy; maintain database. Ability to research issues, think critically, exhibit excellent verbal and written communication skills, learn and follow processes, coordinate and meet multiple ongoing deadlines, and understand policies, bylaws, rules and regulations, health care laws and regulations.

Work Experience: 2 years’ office experience, including extensive use of Excel, Outlook, Microsoft office products and software programs. Proficient typing and data entry skills. Experience in a health care setting preferred.

Education Qualifications: Associates degree preferred.

Who we are:

At Lifepoint Health, we provide quality healthcare to rural communities. As a valued member of our team, you will be an integral part of a group working together to elevate Lifepoint's healthcare delivery network. Our network includes 60+ community hospitals, 60+ rehabilitation/behavioral health hospitals, and 250 additional sites of care across the United States. As an organization, we are dedicated to serving communities nationwide by providing exceptional care. We believe in the power of our talented teams and strive to create environments where employees find purpose and fulfillment.

What you’ll do:

As a CSS Credentialing Specialist, you will be responsible for data entering, gathering, and primary source verification of healthcare practitioner information, including in-depth, detailed, or challenging research of information. Primary methods of researching information include phone, fax, e-mail, internet, and letters. This position needs to be knowledgeable in health care, be task oriented, and work with other team members to accurately and timely process documentation as required.

Responsibilities:

Perform primary (e.g., hospitals, licensing boards, etc.) and secondary source verifications of perspective providers' credentials with special emphasis on provider issues relating to malpractice claims, privileging, criminal concerns, license anomalies and discrepancies in education Responsible for gathering and verifying physician information, compiling required documents, researching necessary information and verifying medical licenses; scrutinize provider applications and resumes for consistency and accuracy Compiles documents, researches and verifies provider backgrounds by contacting hospitals, licensing boards, medical schools, etc. Contacts or interviews provider peer references over the phone about the providers clinical performance skills.

What you’ll need:

Education: HS Diploma or GED required. Experience: 1 year of medical staffing credentialing required.

Why choose us:

As a team member of the Health Support Center, our goal is to support those that are in our facilities who are interfacing and providing care to our patients and community members. Our focus is to attract, retain, and empower a diverse and determined workforce. Our mission statement is at the heart of who we are and what we do: “Making Communities Healthier.” In this shared mission, we believe that our collective efforts will shape a healthier future for the communities we serve.

Benefits: We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, generous Employee illness benefit (EIB), medical, dental, vision, tuition reimbursement, and an Employee Assistance Program. We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran

General Position Summary:

The Credentialing Coordinator is responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of medical staff and allied health professional credentialing and privileging. The Coordinator follows up on the status of applications, tracking progress on all pending and completed work.

Essential Functions / Major Responsibilities:

· Monitor and maintain practitioner medical staff and health plan credentialing expirables. · Maintains practitioner credentialing files electronically via MDStaff, practitioner enrollment software, shared computer files, and CAQH (Council for Affordable Quality Healthcare) · Successfully implements the entire credentialing and recredentialing process for the organization. Coordinator must maintain timelines, communicate with practitioners and other departments to update information as needed and maintain a strict level of confidentiality for all matters pertaining to practitioner credentials. · Updates and distributes medical staff roster, provider contact preference list, provider office phone list. · Maintains confidential credentials, files, and electronic medical staff database. · Responds to correspondence both internally and externally. · Interfaces regularly with internal staff and acts as a Summit liaison for practitioners and health plans related to the credentialing process. · Manages, coordinates, and monitors all aspects of the initial appointment, provisional appointment and reappointment and privileging process to ensure accurate and timely credentialing for prospective members of the medical staff. · Prepares and disseminates notices of final action on applications, new privileges, provisional reviews, reappointments, and changes in staff status; Update and maintain clinical privileges on the hospital-wide system. · Facilitates Medical Staff compliance with regulatory requirements for hospital accreditation to include, but not limited to, National Committee for Quality Assurance (NCQA), Det Norske Veritas Germanischer Lloyd (DNV GL), and Centers for Medicare & Medicaid (CMS). · Assist with any outstanding/pending credentialing related issues.

Secondary Functions: · Cross-trains with other Coordinators in department providing coverage/assistance as needed. · Responsible for security and maintenance of all credentials files. · Continuously evaluates, proposes, and implements medical staff services procedures to standardize and ensure for accuracy and completeness. Ensures compliance with State and Federal requirements and Accreditation standards; interprets, explains, and follows all regulatory guidelines and Federal and State laws and regulations. · All other duties as assigned.

Provides effective communication and guidance to the Medical Staff and APP Staff with regard to all functions of the Medical Staff governance. Maintain confidentiality and compliance with Medical Staff, hospital licensure, Joint Commission, DNV, and other applicable laws & regulatory standards.

• Minimum (1) one year experience in Medical Staff Services or hospital setting.
• Prefer NAMSS CPCS or CPMSM certification.
• Prefer MD-Staff certification.
• Prefer intermediate or higher-level experience with Excel.