GENERAL SUMMARY OF DUTIES: The Medical Staff Services Specialist is responsible for key functions related to maintaining accurate and compliant provider files in Verity Credential Stream credentialing and recredentialing for gastroenterology and anesthesia providers and supporting medical staff governance meetings and documents (bylaws rules regulations etc..
REPORTS TO: General Counsel and Compliance Officer
RESPONSIBILITIES: Duties may include but are not limited to:
Initiate and support the practitioner application process by sending receiving and analyzing practitioner documents and data import to determine completeness in preparation for the credentials verification process.
Responsible for gathering and verifying highly confidential and sensitive health care practitioner credentials consistent with departmental guidelines and accreditation standards.
Manages key credentialing functions such as APP/CAA pairings primary source verification background screenings etc. to secure and maintain privileges.
Efficiently performs all aspects of verification including initial appointment and reappointment to ensure current credentials and timely handoff and/or review and approval of practitioner files.
Respond to all practitioner client health plan and internal inquiries in a timely manner.
Monitor expiring licensure board and professional certifications and other expirable documents within the prescribed timeframe to maintain complete and compliant provider files.
Responsible for accurate enter data to assure the integrity of credentialing information in applicable database(s).
Professionally interfaces with providers to gather information as needed.
Collaborate with participating clients department managers and /or external agencies to facilitate and ensure smooth handoff during the credentialing process.
Creates and maintains professional working relationships with hospital medical staff offices and partners to evaluate and grant privileges for AGA providers.
Use critical thinking skills to conduct followup with individual practitioners and internal and external entities to resolve discrepancies identified during the credentialing process.
Follow credentialing accreditation and regulatory standards.
Participate in accreditation/certification surveys where needed.
Perform other duties as assigned to meet the goals and objectives of the organization.
REQUIRED EDUCATION SKILLS & EXPERIENCE: Bachelors degree in business healthcare or related field and 57 years of progressive experience in credentialing/privileging strongly preferred. 10 years of privileging/credentialing experience may be substituted in place of a degree.
Working knowledge of credentialing/privileging software preferred ideally Verity Credential Stream. Knowledgeable in all aspects of provider credentialing/privileging including knowledge of regulatory & compliance standards credentialing processes and medical staff privileging. Must be proficient in Microsoft Office suite. Strong communication skills from team level to peer level to Csuite level required.
PHYSICAL/MENTAL/ENVIRONMENTAL DEMANDS Requires sitting and standing associated with a normal office environment. Travel (local and nationwide) as business needs dictate.
DRUG FREE WORKPLACE United Digestive is a drug free workplace. All offers of employment are contingent upon passing a preemployment drug screening.
EQUAL OPPORTUNITY EMPLOYER United Digestive MSO Parent LLC is an Equal Opportunity Employer and does not discriminate based on race religion gender color or national origin in its employment practices.
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