Medical Credentialing Specialist - USA Health Shared Services

Overview

USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education, and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists, and researchers provides the region's most advanced medicine at multiple facilities, campuses, clinics, and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall well-being of our community.

Responsibilities

• Abides by and enforces all compliance requirements and policies and performs these responsibilities in an ethical manner consistent with the organization's values.
• Adheres to hospital policies including confidentiality.
• Assists with the orientation of new employees.
• Requires minimal supervision to safely perform functions.
• Utilizes proper body mechanics when moving equipment and or supplies that are necessary to perform essential functions.
• Provides oversight of credentialing verification and validation activities performed by RLDatix the Credentialing Verification Organization (CVO) to ensure accuracy, consistency, and compliance with organizational, regulatory, and accreditation requirements to include:
• Verifications of education, medical school or ECFMG, internship, residency and fellowship and obtains reference from program director for residency and/or fellowship for initial appointments.
• References from other hospitals and physicians for initial appointments and reappointments.
• AMA information for initial appointments and reappointments.
• Verification of current state licensure, state-controlled certificate, DEA, Board Certification, various other required certifications at initial appointments and reappointments.
• Verification of Medicare sanctions for initial appointments and reappointments, queries National Practitioner Data Bank on all initial appointments and reappointments.
• Queries for criminal background checks via the Internet for initial appointments when applicable.
• Reviews the initial and reappointment credentials packets and submits for presentation to the USA Hospitals Combined Credentials Committee for review and approval.
• Prepares and processes temporary privileges as needed for initial applications or Important Patient Need applications with approval of appropriate Department Chairs and hospital leadership.
• Assists RLDatix with the processing and distributing the board letter to all appointees after privileges are granted.
• Verifies that appropriate privileges granted are viewable on the Employee Hub.
• Follows up with the Department/Service Line Chair{s) concerning privilege checklists, requesting additional documentation or training as needed.
• Sends invitation to the Medical Staff and accept the RSVPs to the General Medical Staff Meeting. Assist as needed for this after business hours function).
• Prepares agenda and meeting material for the General Medical Staff Meeting, when needed.
• Orders office supplies as needed.
• Prepares various reports as required.
• Processes request for hospital affiliation letters.
• Processes PMM forms to add or revise physicians to the various computer programs used throughout USA Health.
• Maintains accurate and complete credentialing files to include electronic, software data, and electronic storage files.
• Communicates and uses appropriate customer relation skills with physicians, healthcare team and staff in person, via written correspondence such as emails, and via telephone.
• Accepts and completes all duties positively and without conflict.
• Cooperates, helps others.
• Participates when assigned to serve on committees.
• Completes all mandatory department, educational and hospital requirements
• Adheres to current Infection Control and Safety Standards
• Regular and prompt attendance
• Ability to work schedule as defined and overtime as required
• Related duties as assigned

Additional Information Employees must be in a regular position, working 20 hours or more per week (.50 FTE or greater) to qualify for benefits.

Qualifications

• High School Diploma or equivalent and 5 years secretarial/clerical experience in a medical business office Required
• Credentialing experience is Preferred
• Comparable combination of education and experience may substitute for the above requirements.

Knowledge, Skills, And Abilities

• Working knowledge of Microsoft 365 MediumWorking knowledge of Microsoft 36