CREDENTIALING COORDINATOR - MEDICAL STAFF SERVICES

Cook CountyChicago, IL
21hOnsite

About The Position

The primary responsibility of this position is coordinating and processing health system practitioners and non-practitioners initial appointments and reappointments, in accordance with associated bylaws, rules and regulations, department policies and procedures. The position will manage the medical staff credentialing program and supports Medical Staff Office (MSO) function for practitioners and other non-practitioners located throughout Cook County Health (CCH) affiliates including John H. Stroger, Jr. Hospital, Provident Hospital, the Ambulatory Healthcare Network, Cook County Department of Public Health, Ruth Rothstein CORE Center and the Cermak Correctional Health Services. This position adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. Individual credentialing responsibilities for all Cook County Health (CCH) Credentialing Coordinators are assigned by the CCH Medical Staff Services Director and processed in accordance with department policies and procedures.

Requirements

  • High school diploma or GED with Three (3) years of prior work experience processing medical staff applications in a healthcare or hospital system OR Bachelors degree from an accredited college or university with one (1) year of prior work experience processing medical staff applications in a healthcare or hospital system (must provide official transcripts at time of interview)
  • Experience and knowledge of medical terminology
  • Experience and knowledge of provider enrollment with health plans
  • Prior experience interacting with Credentials Committees
  • Proficiency with credentialing software products or similar database applications
  • Must be able to export reports from the database and create spreadsheets
  • Proficiency with Microsoft Office products Word and Excel

Nice To Haves

  • Bachelor’s degree from an accredited college or university
  • Certified Provider Credentialing Specialist (CPCS)
  • Certified Professional in Medical Services Management (CPMSM)
  • Knowledge of medical staff services policies and procedures, as well as accrediting and regulatory standards.
  • Knowledge of medical staff administration and credentialing principles
  • Knowledge of medical terminology
  • Strong interpersonal skills and the ability to communicate effectively with physicians, administrators, and CCHHS departments/staff throughout the health system.
  • Demonstration of the utmost professionalism to multiple internal and external customers.
  • Ability to maintain confidential information.
  • Ability to work independently and determine work priorities.
  • Ability to handle a variety of problems and situations, often of an extreme confidential or urgent nature

Responsibilities

  • Ensures the completeness of the initial and reappointment process by conducting primary source verification as applicable for licensure, education, training, affiliations, board certifications, hospital affiliations and malpractice history.
  • Completes provider enrollment as CCH managed care initiatives expand.
  • Logs, scans and processes a variety of transactions related to credentialing timeframes and follow-up for statistical reporting on behalf of the CCH and assigned areas.
  • Prepares completed credentialing applications and reapplications packets for department and division Chair review and recommendations to appropriate committee for approval.
  • Assists with the preparation of medical staff Credential Committee agendas and ensures appropriate follow-up action is taken in a timely manner.
  • Develops and maintains a current knowledge base in the area of Medical Staff Services and its relationship within the hospital's organizational structure and to outside agencies.
  • Participates in data collection and department performance improvement initiatives, including audits, and, focused and ongoing performance evaluations as directed by Credentials and Medical Executive Committees.
  • Performs data entry and conducts electronic processes as required for the Morrisey credentialing software system.
  • Assigns provider privileges, as approved by the governing body, into Web based privilege platform.
  • Ensures a confidential credentialing record process including paper files, databases, and communications
  • Reviews credentialing files to assure compliance with accreditation and regulatory requirements (Illinois Department of Public Health, Centers for Medicare and Medicaid Services, The Joint Commission, National Committee for Quality Assurance) related to medical staff credentialing and competence of assessment of privileged practitioners.
  • Processes medical staff status and privilege changes in accordance with department policies and procedures.
  • Collects and tracks reappointment late fees in accordance with Medical Executive Committee policies.
  • Participates in regulatory and accreditation surveys across the CCH.
  • Provides customer service to professional applicants, department and medical staff committee chairs, hospital administrators, and support staff as related to area of responsibility and to ensure effective communication.
  • Performs other duties as assigned by Medical Staff Services Director and on behalf of the CCH medical staff.

Benefits

  • Medical, Dental, and Vision Coverage
  • Basic Term Life Insurance
  • Pension Plan and Deferred Compensation Program
  • Employee Assistance Program
  • Paid Holidays, Vacation, and Sick Time
  • You may also qualify for the Public Service Loan Forgiveness Program (PSLF)
  • For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/
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