The Medical Staff Services Supervisor is responsible for oversight and management of the medical staff services processes including OPPE/FPPE, Peer Review, and credentialing, in addition to ensuring compliance with National Committee on Quality Assurance (NCQA), The Joint Commission (TJC) standards, Centers for Medicare/Medicare (CMS), state and federal law.

Ensure timely review of OPPE, FPPE, and credentialing while maintaining data integrity within the system. Coordinate workflow between the various departments in Medical Staff Services. Assist with the maintenance of department policies and standard work.

Supervision of Medical Staff Services team members to ensure optimization of resources and manage workload. Facilitate developmental conversations for direct reports. Work collaboratively with the Director of Medical Staff Services to achieve team goals.

Education Qualifications: Educational Requirements:

Associates Degree in a related field Required Qualifications:

Minimum of 1-2 years supervisory experience or equivalent experience Preferred Qualifications:

NAMSS (National Association of Medical Staff Services) certification; either CPCS (Certified Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) Working knowledge of medical staff/provider credentialing concepts and comprehensive knowledge of state, federal regulatory requirements and accreditation standards relating to the organized medical staff

Job Summary:

The Credentialing Specialist primarily serves as the liaison between Vision Radiology and our contracted Radiologists. Duties include maintaining detailed records of Radiologists, maintaining a database, and verifying credentials for both initial and reappointment applications. In addition, he/she may be tasked with special projects pertaining to the Physician Services Department as needed.

Department: Physician Services

Position: Credentialing Specialist

Supervision: Reports to the Physician Services Manager

About Vision Radiology:

Vision Radiology® was formed in 2003 by several radiology alumni from The Johns Hopkins University. We shared the same core values with respect to our dedication to diagnostic radiology and our commitment to patient welfare. Our Vision was to work together to serve local radiology practices and their patients across the country during understaffed hours. We have since been joined by numerous other radiologists of the same mold, predominantly alumni of Johns Hopkins and Stanford University. We serve several of the country's most prestigious institutions and have a reputation as the gold-standard in teleradiology.

Requirements and Qualifications:

Minimum of High School Diploma or equivalent required Minimum of 1-year of administrative experience in Healthcare desired Other skills, abilities, and knowledge must include: an effective communicator who consistently demonstrates above-average verbal and written skills capable of learning and working effectively in a remote environment with minimal supervision in possession of strong data-entry skills detail-oriented and highly organized in possession of sound judgmental and critical-thinking skills an engaged and collaborative employee who can constructively receive and share feedback adaptable to changes in internal and external processes and priorities Job duties:

Initiate and manage initial and reappointment credentialing processes as assigned Determine target dates and meet deadlines for obtaining clinical privileges Work proactively to resolve issues before they impact the Organization, Healthcare Entity, and/or patient Ensure timely and accurate completion of verifications and credentials documentation Establish and maintain positive working relationships with all Organization and Healthcare Entity staff Strictly comply with all Organization and Healthcare Entity Bylaws and policies, accrediting body standards, and laws governing the healthcare industry Maintain credentialing database with a high level of accuracy, detail, and consistency in record-keeping practices Properly utilize any computer software program(s) necessary to support Physician Services functions Other duties as assigned Important notes:

This position is primary work from home.

We have an office in Dallas, TX as well as Minneapolis, MN; this role may require travel to either location throughout the year.

Job Type: Full-time

Salary: $50,000.00 - $55,000.00 per year

Benefits:

401(k) Dental insurance Flexible spending account Health insurance Paid time off Vision insurance Schedule:

8 hour shift Day shift Monday to Friday Experience:

Microsoft Office: 1 year (Preferred) Microsoft Word: 1 year (Preferred)

Coordinate system-wide facility payer enrollment. Provide guidance and support to physician and non-physician leadership; Coordinate facility expirables; research facility enrollment issues and claim denials; audit physician/credentialed provider/facility paperwork for accuracy; maintain database.

Work Experience:

• Minimum of two years’ experience in an office setting, preferably healthcare.

• Preference for experience in facility payer enrollment

• Experience researching issues, thinking critically, learning and following processes, coordinating projects, meeting multiple ongoing deadlines, and interpreting and understanding policies, bylaws, rules and regulations.

• Extensive knowledge and experience with Excel, Outlook Microsoft office products and software programs.

• Experience with payer portals including I&A, PECOS, MPSE, MMIS, Forward Health, etc. Preferred but not required

• Excellent verbal and written communication skills and attention to detail.

• Experience with staffing meetings, and working with leadership, preferred.

Education Qualifications: Associates degree preferred

Licensure/Certification Qualifications: No certification/licensure required.

FTE: 1 Possible Remote/Hybrid Option:

Remote Shift Rotation: Day Rotation (United States of America) Shift Start Time: 8:00 am Shift End Time: 4:30 pm

The Credentials Coordinator manages the medical staff credentialing program and supports Medical Staff Organization function by:Processing medical staff applications for appointment and reappointment in a timely manner. Facilitating and supporting medical staff credentials and privileges committee. Serving as liaison and problem solver to clinical department administrative and practice plan staffs and physicians.Designing and preparing computer database reports, statistics, rosters, etc. for routine and special requests

Essential Job Functions:

Process medical staff applications for appointment and reappointment. Ensure applications are processed and reviewed in a timely fashion. This includes verifying and analyzing the accuracy and completeness of the application and proof of current licensure, malpractice insurance coverage, etc. Verify and evaluate past clinical training, present and past hospital medical staff affiliations and clinical privileges which have the potential for high risk exposure for the Medical Center. Facilitate and support medical staff credentials and privileges committee, as well as Laser committee.Ensure appropriate follow-up action is taken. Serve as liaison and problem solver to the clinical department administrative and practice plan staffs and physicians regarding credentialing issues. QUALIFICATIONS:

Bachelor’s Degree in appropriate field. Knowledge of medical staff administration and credentialing principles normally acquired through 3-5 years’ experience in the field. Knowledge of Joint Commission, DNV, NCQA, CMS, State of Illinois Regulatory Standards, and State of Indiana Regulatory Standards. Knowledge of medical terminology. Initiative, experience in decision-making, detail oriented and independent work habits. Must be able to handle a variety of problems and situations, often of an extremely confidential or urgent nature. Excellent PC skills, including internet and database (Access preferred) experience. Must be organized and able to handle multiple priorities and consistently meet deadlines. Excellent communication skills, both oral and written. Excellent interpersonal skills to develop and maintain effective working relationships with physicians and department staffs and other customers.

LICENSES/CERTIFICATIONS

CPCS or CPMSM preferred

Why Join Us Join UChicago Medicine as a Credentials Coordinator.

The Credentials Coordinator manages the medical staff credentialing program and supports Medical Staff Organization function by:Processing medical staff applications for appointment and reappointment in a timely manner. Facilitating and supporting medical staff credentials and privileges committee. Serving as liaison and problem solver to clinical department administrative and practice plan staffs and physicians.Designing and preparing computer database reports, statistics, rosters, etc. for routine and special requests

Essential Job Functions:

Process medical staff applications for appointment and reappointment. Ensure applications are processed and reviewed in a timely fashion. This includes verifying and analyzing the accuracy and completeness of the application and proof of current licensure, malpractice insurance coverage, etc. Verify and evaluate past clinical training, present and past hospital medical staff affiliations and clinical privileges which have the potential for high risk exposure for the Medical Center. Facilitate and support medical staff credentials and privileges committee, as well as Laser committee.Ensure appropriate follow-up action is taken. Serve as liaison and problem solver to the clinical department administrative and practice plan staffs and physicians regarding credentialing issues.

QUALIFICATIONS:

Bachelor’s Degree in appropriate field. Knowledge of medical staff administration and credentialing principles normally acquired through 3-5 years’ experience in the field. Knowledge of Joint Commission, DNV, NCQA, CMS, State of Illinois Regulatory Standards, and State of Indiana Regulatory standards. Knowledge of medical terminology. Initiative, experience in decision-making, detail oriented and independent work habits. Must be able to handle a variety of problems and situations, often of an extremely confidential or urgent nature. Excellent PC skills, including internet and database (Access preferred) experience. Must be organized and able to handle multiple priorities and consistently meet deadlines. Excellent communication skills, both oral and written. Excellent interpersonal skills to develop and maintain effective working relationships with physicians and department staffs and other customers

LICENSES/CERTIFICATIONS

CPCS or CPMSM preferred

• Send out applications
• Preview and prepare applications for processing
• Assist in Processes initial applications

We have a Full Time Credentialing Specialist. We need some extra help in processing applications.

Position could be in-person, but will offer remote to right candidate with Credentialing and MDstaff experience.

Provides management support and coordination for all medical staff, medical education and continuing education services. Maintains productive, professional relationships with all levels of staff. Develops departmental plans, budgets and directs staff as appropriate. Maintains knowledge of the medical staff and medical education standards as related to deemed agencies, state law, and other regulations to assure compliance.

MANAGER OF MEDICAL STAFF SERVICES - R3522 Denver Health Medical Center

Denver Health Medical Center is recruiting for a Manager for our Medical Staf Services division. The Manager of Medical Staff Services administers the medical staff office credentialing and reappointment. Directs, plans, organizes, and manages the daily activities of the medical staff credentialing specialists and is responsible for preparation, organization, and follow-up involved in maintaining accreditation with The Joint Commission as it relates to Medical Staff Services. Responsible fo establishing and maintaining continuity in the planning, development, and implementation of standards applicable to the medical staff that relate to credentialing, privileging, bylaws, and rules and regulations. Collects medical staff dues. Coordinates and provides support for medical staff committee meetings and support of administrative functions. Collaborates in the FPPE and OPPE process.

Essential Functions:

Manages, instructs and reviews staff to complete all privilege packets accurately and completely to comply with TJC and NCQA standards. Provides orientation for medical staff office employees. (20%) Coordinates credentialing process for Medical Staff and Allied Health Professional Staff. (20%) Monitors all incoming privilege packets, applications, and credentialing records for optimal distribution to facilitate timely and accurate retention of documentation. Review and report on all staff and department credentialing and privileging each month. (20%) Identifies problems or opportunities for improvement, formulates solutions, involve others in the implementation as necessary and required. (20%) Assumes administrative responsibility for the Medical Staff Office including employee selection, evaluation, disciplinary action and termination. (10%) Attends Medical Staff Executive Committee and related meetings when necessary. Promotes positive interpersonal (customer) relationships with fellow employees, physicians, patients and visitors. Treats these individuals with courtesy, dignity, empathy and respect; consistently displays courteous and respectful verbal and non-verbal communications. Adheres to, complies with and demonstrates support for the mission and values of Denver Health. Supports and adheres to the Denver Health Dozen Sets clear expectations for staff by developing job specific customer service expectations and behaviors for each position supervised; clearly communicates expectations to each employee and establishes the expectations as job requirements and performance evaluation components; delegates responsibility/authority whenever possible. Has regular and predictable attendance. Identifies training and staff development needs of employees and ensures appropriate training provided. (5%) Performs QA function for bylaws and P & P's at least annually, or more frequently as needed. (5%)

Education:

Bachelor's Degree Required

Work Experience:

4-6 years Of experience in a hospital medical staff office Required and 1-3 years Of supervisory experience Required

Licenses:

CPMSM-Certified Professional Medical Services Management - NAMSS - Education Advocacy Patient Safety Required

Knowledge, Skills and Abilities:

Working knowledge of accreditation process and standards, health care and credentialing industry, regulatory and legal requirements and other national standards is required. Experience working with medical staff governance processes is essential Possess excellent organizational skills, attention to detail, technical and analytical skills. Demonstrate discretion, diplomacy, and good judgment. Able to maintain a high degree of confidentiality and diplomacy. Strong leadership and conflict management/mediation skills. Ability to work independently and effectively with internal and external stakeholders at various levels of responsibility. Proficiency in the Microsoft Office suite of products (i.e. Word, Excel, Access, Power Point) required. Experience using credentialing software (MD Staff) required. Familiarity with the Epic electronic medical record system preferred.

Benefits

Competitive pay

Outstanding benefits

Education opportunities

Shared leadership and advancement opportunity

State-of-the-art facilities

Immediate retirement plan matching

Professional clinical advancement program

Participation in evidence-based projects

Public Service Loan Forgiveness (PSLF) eligible employer

National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

Respect

Belonging

Accountability

Transparency

All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.

As Colorado's primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).

Contact Information Jamie Krentz jamie.krentz@dhha.org

Visit https://www.denverhealth.org/for-professionals/careers for more information. Key words; Manager, Medical Staff Services - R3522

This position performs both Provider Enrollment and Patient Registration functions. For Provider Enrollment, the position is responsible for assisting the revenue cycle team by performing Provider enrollment activities. The position works with University and UCM departments, payers other external entities to obtain the necessary information needed to complete enrollment thereby enabling billing for provider services. Also performs billing workflows (e.g. work edits related to provider enrollment, resolve Payer system edits related to provider enrollment, etc.) and review/resolve complex provider enrollment issues. For Patient Registration, the position is responsible for performing patient registration or updates to patient registration in order to assure that patient demographic and insurance coverage information is accurate to facilitate billing to patient, insurance coverage and/or other third party entities. References third party insurance information to validate and update insurance coverage. Resolves system edits related to registration/insurance coverage to facilitate billing. Assumes responsibility as a proactive resource and subject matter expert for both provider enrollment and registration activities. Responsibilities:

• Obtains required information from Providers and their departments in order to complete provider enrollment applications.
• Submits applications for designated payers including IL Medicare, IL Public Aid, IN Public Aid, and Railroad Medicare. Tracks status of enrollment applications and performs follow-up activities as indicated to ensure enrollment is completed in a timely manner
• Performs re-certification/re-validation of enrollment per schedule mandated by payers.
• Troubleshoots and resolves enrollment issues related to claims for provider services and contacts payers, UCMC Departments or UCPG A/R Team to resolve. Re[1]submits claims to payers once enrollment issues are resolved.
• Participate in annual and on-going mandatory compliance training and maintain knowledge of regular updates on billing compliance regulations. Keep informed of changes in policy by reviewing regular Medicare, Medicaid and other payer bulletins and/or other relevant resources. Be knowledgeable of and continually be in compliance with all federal and state health care laws, regulations, and rules (including Medicare and Medicaid billing requirements that are applicable to the employee's job duties).
• Completes patient registration or updates to patient registration using Epic system. Uses third party system data to validate insurance coverage and to accurately assign insurance coverage for the patient in the Epic system. Accurately determines the correct plan code to select for assignment of insurance coverage.
• Works system edits related to patient demographic and insurance coverage so that claims or statements are accurately sent to insurance companies/other third party payers or patients.
• Troubleshoots complex issues related to registration/insurance coverage and accurately resolves the problem so that claims can be properly adjudicated and paid (goal is payment on first submission).
• Identifies issues, along with underlying root cause analysis, and assists with solutions that provide resolution or enhances business workflows. Competencies:
• Demonstrated ability to interact and communicate with clarity, tact, and courtesy with patrons, patients, staff faculty, students, and others.
• Demonstrated ability to participate as a member of the Team in identifying priorities for the work unit and participate as a member of a work group or team.
• Demonstrated ability to work with supervision to identify and describe work task priorities.
• Demonstrated ability to communicate effectively in English, both orally and in writing.
• Demonstrated ability to recognize and resolve or refer problems and conflicts. Must be able to remain calm and professional when dealing with an upset provider or other customer
• Demonstrated ability to negotiate and manage interpersonal communication effectively.
• Confidentiality/discretion must be maintained at all times as will be handling confidential and sensitive information.
• Ability to handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere. • Ability to work with minimal supervision required.
• Ability to report to work on time, per schedule and to maintain professional dress/appearance.
• Ability to work for long periods of time in a sitting position, or at a keyboard.
• Ability to bend/kneel to access files in filing cabinets or storage boxes.
• Ability to drive or commute to various sites for occasional meeting.
• Ability to work flexible hours on occasion