CREDENTIALING SPECIALIST (CHIEF MEDICAL ADMINISTRATION)

Essential Duties, Functions And Responsibilities

• Ensures the proper execution of the credentialing and privileging process for the Medical Staff, including requests for appointment, reappointment, expansion or reduction of privileges, temporary membership, temporary privileges, and verification of current licensure.
• Ensures compliance with Centers for Medicare and Medicaid Services (CMS) requirements, FDIHB credentialing policies and FDIHB Bylaws of the Medical Staff.
• Oversees and completes background research on all applications such as:
  • Verification of education, training and experience.
  • Obtaining reference from other hospitals and health professionals.
  • Verification of state license(s).
  • Verification of malpractice concerns via National Practitioner Data Bank (NPDB) and other sources.
  • Verification of Continuing Medical Education (CME).
  • Verification of current competence and professional conduct through peer recommendations.
• Provides notification to medical staff of any expiring license, board certification, and Drug Enforcement Agency (DEA) number.
• Prepares and distributes Medical Executive Committee (MEC) list for appointment, reappointment for permanent, temporary and consulting staff.
• Provides general medical staffing reports as requested by the Chief Medical Officer and Chief of Staff.
• Provide regular communication with the Provider Enrollment Team and Medical Staff Recruiter and other team members to ensure a timely provider onboarding.
• Afford assistance with coordination of Medical Staff Meetings.
• Receives telephone calls and visitors; screens inquiries, takes care of routine matters, referring callers/visitors to appropriate personnel.
• Establishes and maintains an efficient filing system for the credentialing documentation.
• Prepares a variety of materials such as correspondence, reports, technical documents, requisitions, forms, meeting minutes and memos using automated systems.
• Receives reviews and distributes incoming correspondence related to the medical staff credentialing.
• Maintains control of correspondences and action documents to enable follow-up status and/or progress to ensure timely action in accordance with established requirements and deadlines.

Mandatory Minimum Qualifications

• Experience: One (1) year of direct experience in credentialing and medical staff privileging Or Three (3) years’ experience in a medical staff support role Or One (1) year experience in payor/provider enrollment
• Education: Associate Degree or equivalent direct experience.

Other

• Please email degree, transcripts, license & certifications to vanessa.apachee@fdihb.org
• * NAVAJO/INDIAN PREFERENCE FDIHB and its facilities are located within the Navajo Nation and, in accordance with Navajo Nation law, has implemented a Navajo/Indian Preference in Employment Policy.