26113 - Medical Staff Coordinator

About the role

Credentials and administers day-to-day support of the credentialing and privileging process for West Virginia University Hospitals and West Virginia United Health Systems.

Responsibilities

• Coordinates the timely credentialing, recredentialing and privileging of new and current Physicians, Dentists, Licensed Independent Practitioners and Advanced Practice Professionals following Joint Commission and National Committee for Quality Assurance (NCQA) standards.
• Maintain working knowledge of Joint Commission, NCQA, State Medical Boards and Centers for Medicare & Medicaid Services (CMS) standards.
• Makes sure the credentialing process stays up-to-date, including applications for appointment, reappointment, clinical privilege forms and policies, ensuring compliance with Joint Commission, NCQA and CMS standards.
• Performs Primary Source Verifications of practitioner information in compliance with Joint Commission, NCQA and CMS standards.
• Enters, maintains and updates practitioner information into the electronic credentialing software in an accurate and timely manner.
• Maintains a current knowledge of the Medical Staff Bylaws, Rules & Regulations and Credentialing policies.
• Participates in Joint Commission, Office of Health Facility Licensure & Certification (OHFLAC) and Managed Care Organization (MCO) surveys as it relates to the credentialing and privileging of Physicians, Dentists, Licensed Independent Practitioners and Advanced Practice Professionals.
• Serves as the WVUH liaison to Managed Care Organizations in regard to performing delegated credentialing functions in accordance with contractual agreements.
• Works with Information Technology and the electronic credentialing software vendor to maintain a current system through updates and training.
• Participates in project work identified by the leadership of Medical Staff Affairs.

Requirements

• Education: Bachelor’s degree in business or a health-related field AND one (1) year of experience in an administrative setting.
• OR Associate Degree in business or a health-related field AND three (3) years of experience in an administrative setting.
• OR High School Diploma or equivalent AND five (5) years of experience in an administrative setting.
• Preferred Qualifications: Bachelor’s Degree in business or a health-related field. Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Service Management (CPMSM).

Qualifications

• Experience: Three (3) years’ experience in a medical staff credentialing role, preferably as a Medical Staff Coordinator or equivalent. Experience in a hospital or medical facility.

Skills & Abilities

• Ability to function in a demanding and fast-paced environment.
• Proficient computer skills including, but not limited to thorough knowledge and understanding of office software programs including Windows, Excel, Outlook, or similar applications.
• Possess excellent organizational and prioritization skills.
• Possess professional communication skills.
• Must be detail oriented and possess excellent spelling and grammar skills.