Credentialing Specialist II-Medical Staff

• Performs and monitors all credentialing functions, including complex credentialing issues and brings forward issues to the Medical Staff Credentialing Lead and/or Director
• Interfaces with senior medical staff leaders and administration and presents information when necessary
• Utilizes knowledge of bylaws, rules, and regulations, expertise, sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
• Acts as a liaison between Administration and members of the Medical Staff
• Apply knowledge, expertise, sound judgment and consult other references and resources as necessary to generate and evaluate solutions and recommendations
• Applies knowledge of bylaws, rules, and regulations to effectively serve as a Medical Staff information resource, to ensure timely flow of work, and sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
• Ensures compliance with all applicable Accreditation agencies
• Supports oversite and participate in internal, external, compliance surveys, reviews and audits as required
• Utilizes credentialing software for new and reappointment letters, resignations, leave of absences, changes in staff category, add/delete privileges
• Coordinates, monitors and maintains the credentialing and recredentialing process
• Reviews applications and other data for accuracy and completeness, including processing application fees and other receipts received during the verification process
• Performs primary source verification of initial and reappointments applications by preparing requests for information letters, tracking responses and follow-up for needed information
• Obtains, reviews, and collects accurate data licensure, insurance, and other certificates at time of reappointment. or as they expire) for each applicant in the database and responds to verification requests
• Ensures the accuracy of documentation to support the request for privileges by maintaining good working relationships with clinical departments, Medical Staff leadership and professional agencies
• Answers phones, makes copies, prepares mailings, and maintains files
• Effectively communicates with peers to ensure information regarding practitioners is current
• Supports Medical Staff meetings
• records meeting minutes and maintains an accurate record of decisions as required
• including board letters prepared and distributed as required
• Maintains register of applications and expired certificates/licenses and assists with all mid-cycle updates
• Processes application fees and records deposits as required
• Adheres to TMCH organizational and department-specific safety, confidentiality, values, policies, and standards
• Performs related duties as assigned

• High school diploma or general education degree (GED)
• Two (2) to Four (4) years of medical staff privileging or credentialing experience
• CPCS or CPMSM certification preferred
• Intermediate to Advanced Knowledge of healthcare practices and procedures
• Advanced Skills in maintaining a detailed database, creating reports, and maintaining files
• Intermediate to Advanced Ability to read, analyze, and interpret general business periodicals, professional journals, technical and software related procedures and manuals, governmental regulations
• Display promotes and inspires trust and confidence among team members and stakeholders through reliability, authenticity, and accountability
• Expresses thoughts clearly, concisely, and effectively both verbally and in writing
• Establishes and maintains productive and cooperative relationships with team members, peers, management, and stakeholders both internal and external to the organization
• Intermediate to Advanced ability to effectively present information and respond to inquiries regarding any issue related to the Credentialing and Privileging process
• Intermediate to Advanced skills to define problems, collect data, establish facts, and draw valid conclusions

CPCS or CPMSM certification