When you join the growing BILH team, you’re not just taking a job, you’re making a difference in people’s lives.
Performs all functions necessary to ensure all new and reappointed Medical Staff are credentialed according to the guidelines established by the Medical Staff Bylaws, the Joint Commission, and State and Federal regulatory agencies. This is a 32 hour per week position, full-time benefits.
Essential Responsibilities:
Audit files returned from the CVO for accuracy and completeness according to Bylaws, Joint Commission, State and Federal guidelines. Ascertain any serious issues in need of further investigation. Follow up on information missing from returned files. Speak with providers directly to clarify information. Perform queries to access current license/malpractice verifications.
Enter Cactus/MEDITECH demographic and privileging information. Process dictation codes as applicable. Obtain Peer Review/reference documentation. Effectively communicate verbally and through written correspondence with all levels of providers, Chiefs of Service, Department Chairpersons and office managers and other individuals who are influential or are important to the hospital.
Obtain signatures from Chiefs of Service and Department Chairpersons for credentialing files and Delineation of Privileges. Assist Credentials Committee Chairperson to review files and follow up on issues. Prepare agenda, meeting materials, take minutes. Prepare BOT list after Committee meets. Prepare Welcome and Reappointment notification letters after BOT approval.
Send application requests to MedVentive. Process temporary privileges, resignations and category changes. Maintain Cactus and MEDITECH databases. Maintain provider files for completeness and updated information. File processed applications and prepare old files for storage. Process hospital verifications on a weekly basis. Sort mail and other correspondence.
Required Qualifications:
High School diploma or GED required. Associate’s degree preferred.
0-1 years related work experience required in Credentialing experience.
Strong oral, written communication skills and problem solving skills
Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
Preferred Qualifications:
1-3 years of experience in acute hospital or HMO provider credentialing.
CPCS (Certified Provider Credentialing Specialist).
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