Credentials Administrator Ii Jobs

Under supervision, initiates the credentialing process, compiles, and processes data in compliance with Federal, State, Program, and Regional requirements. Ensures thorough and timely verification of physicians credentials according to regional Credentialing Policies and Procedures. Acts as liaison between medical centers and medical offices credentials and privileges coordinators and the regional office.

Essential Functions:

Ensures consistent documentation and complete verification of physicians credentials. Provides required documentation to appropriate physicians managers and committees in the practice sites.

Processes all credentials applications and/or applications for employment with TPMG.

Initiates extensive investigation into the applicants background, education and experience through the use of on-line systems, written correspondence, telephone inquiries and printed reference guides and reports.

Partners with the practice site Credentials & Privileges Coordinators to ensure an integrated, timely, consistent product.

Collaborates with professional physician recruiters to monitor recruitment status of candidates to ensure timely credentialing prior to employment.

Develops and maintains a computerized data base of physician data for use in the credentialling and appointment process. Prepares reports as requested.

Maintains files of current Scopes of Practice for all specialties, Professional Staff by-laws for all medical center and current Federal, State, Program and Regional requirements.

Implements efficient and effective combinations systems for transmission of credentials information to practice sites to facilitate timely approval to participate and professional staff appointment.

Keeps abreast of changes in laws and regulatory requirements. Writes and implements new procedures as necessary to remain in compliance.

Works with practice site Credentials and Privileges Coordinators to share and implement best practices whenever feasible.

Qualifications:

Basic Qualifications:

Experience

Minimum three (3) years of experience with credentialing in a hospital setting.

Education

Associate's degree required, OR two (2) years of experience in a directly related field.

High School diploma or General Education Development (GED) required.

Additional Requirements:

Proficient with IBM PC, dBase, WordPerfect, and Lotus 1-2-3.

Proficient with Medical Terminology.

Significant knowledge of Federal and State regulatory requirements and accreditation standards e.g., The Joint Commission, TITLE

22, NCQA, NPDB, and certifying agencies.

Strong organization and communication skills and attention to details required.

Proven ability to function independently with minimal direct supervision.

Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:

Experience with Med Staff or Medical Information Data Analysis System preferred.

Bachelor's degree preferred.

Certification as Certified Provider Credentialing Specialist (CPCS) preferred.

Employee Status:

Regular

Travel:

Yes, 10 % of the Time

Job Level: