GENERAL SUMMARY
The Professional Staff Credentialing Specialist reports to the Director of Professional Staff and is responsible for assigned Professional Staff departments, divisions and committee functions to ensure compliance with Bylaws and Rules and Regulations; State and Federal requirements; and accreditation standards. With other Professional Staff Services employees, facilitates all aspects of credentialing including appointment, reappointment and privileging for CHKD Health Systems. Actively seeks to promote and maintain, through interactions with others within and outside the department, a positive, professional, team-oriented and service conscious environment that contributes to the goals of the department and reflects the values and mission of CHKD Health Systems.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Serves as an essential link between senior management and the Professional Staff to promote and enhance good communication and a positive working relationship.
Responsible for the intake processing, primary source verification, analyzing and file preparation and reports for presentation to all Professional Staff Committees and applicable Board Committees for initial applications and reappointment applications.
Maintains current information including licensure, certification, liability coverage, and addresses within the credentialing software database.
Maintains the confidentiality of highly sensitive information regarding the Professional Staff, proceedings, disciplinary actions, and other personal and professional information.
Communicates effectively with outside agencies (i.e., State Board of Medicine, Drug Enforcement Agency, National Practitioner Data Bank, etc.) as well as other departments, hospitals, insurance companies and managed care organizations to obtain or share, as authorized, information regarding physician credentials or privileges.
Interacts effectively with the Professional Staff Quality Manager to integrate quality of care issues into the reappointment process.
Facilities and attends, as assigned, committee, general staff and department meetings. Secures meeting rooms, arranges for catering and special equipment needs for above meetings.
Assures that committee discussions cover agenda topics and may assist in preparing agendas.
Prepares minutes of meetings, or directs preparation of minutes for dissemination to members and others among senior leadership.
Records conclusions and recommendations accurately to substantiate actions taken by departments or committees. Maintains and protects the confidential records of proceedings which may be required in subsequent internal investigations and/or legal disputes.
Participates in accreditation surveys, as assigned.
Maintains confidential electronic and/or paper filing systems, as appropriate, for all current and archived physician files.
With other Professional Staff Services employees, provides telephone coverage for the department, responding to a variety of requests for information or services.
Provides current and accurate information on legal issues/requirements and pertinent regulatory standards using state, federal and regulatory guidelines.
Notifies the Professional Staff of upcoming meetings and special events.
Prepares a Professional Staff roster for use by internal departments.
Prepares ongoing reports and monitors reappointment cycles to ensure compliance with accreditation standards related to re-credentialing timeframes.
May be asked to assist the Director in the creation and development of policies and procedures for the Professional Staff and internal operation.
LICENSES AND/OR CERTIFICATIONS
CPCS and/or CPMSM certification by the National Association Medical Staff Services (NAMSS) preferred.
MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS
High school diploma or equivalent required. College degree preferred.
At least 3 years previous credentialing experience required.
Basic statistical knowledge and experience required.
Must have excellent analytical, problem-solving, organizational and prioritizing skills.
Strong oral, written and interpersonal communication skills.
Effective meeting management skills required.
Proficiency in Microsoft Office products.
Working knowledge of accreditation standards related to credentialing.
WORKING CONDITIONS
Fast paced, extremely busy office environment where interruptions are frequent. Works in a normal office environment with little exposure to excessive noise, dust, temperature and the like.
PHYSICAL REQUIREMENTS
Click here to view physical requirements. (https://www.chkd.org/uploadedFiles/Documents/Employees/Category%20A%20Jobs.pdf)
