Job Description

I. General Summary

• Under general supervision of the Medical Staff Services Director, the Coordinator will complete all aspects of the credentialing and re-credentialing process in compliance with the UMMC Midtown Campus Bylaws, the Standards of The Joint Commission (“TJC”), and the National Committee for Quality Assurance (“NCQA”) Standards and applicable State and Federal regulations

II. Principal Responsibilities and Tasks

1. Prepares and distributes credentialing and re-credentialing application packets.

2. Secures required information relating to credentialing and re-credentialing in a confidential manner.

3. Identifies and evaluates potential application red flags and works in collaboration with Division Head/Department Chief to resolve.

4. Secures copies of malpractice claims as reported during credentialing and re-credentialing and by BPQA and completes legal summaries for each.

5. Collaborates with responsible internal departments the preparation and compiling data analysis of OPPE and FPPE reports that are required as part of the evaluation and decision processes of the governing bodies according to required timeframes.

6. Organizes and prepares credentials files for appropriate monthly departmental and committee review.

7. Processes initial and re-credentialing applications within required timeframes.

8. Ensures that all expirables are reviewed and obtained on a monthly basis.

9. Maintains the accuracy and integrity of the credentialing and clinical privileging database system.

10. Assists in the ongoing compliance with all appropriate accrediting and regulatory agencies including the facilitation of periodic delegated credentialing audits.

11. Collaborates with the responsible internal departments in the new appointment or rotating resident’s on-boarding process.

Qualifications

III. Education and Experience

1. High School Diploma or equivalent (GED) is required. Associates or Bachelor’s degree preferred.

2. NAMSS CPCS certification preferred, and/or working toward certification

3. Three (3) years minimum in the field of healthcare credentialing required.

IV. Knowledge, Skills and Abilities

1. Highly effective verbal, written and interpersonal communication skills to communicate effectively with all levels hospital staff, patients, visitors, and levels of staff.

2. Basic skill in Microsoft Office Suite required

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation

• Pay Range: $21.312-$26.048
• Other Compensation (if applicable):
• Review the 2024-2025 UMMS Benefits Guide