Medical Staff Credentialing Coordinator
Albuquerque, NM 
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Posted 14 days ago
Job Description
Medical Staff Credentialing Coordinator
Requisition ID 2024-40195 Category Provider Services Location : Name Presbyterian Hospital Location : City Albuquerque Location : State/Province NM Minimum Offer USD $18.58 Maximum Offer for this position is up to USD $28.36
Overview

Now hiring a Medical Staff Credentialing Coordinator to support the Medical Director Department!


Supports the Medical and Allied Health Staff credentialing/primary sourcing verification program by coordinating and developing internal processes in order to meet requirements of federal and state regulatory and national accreditation agencies. Monitors timeliness of processes and provides feedback and/or reports to the appropriate manager. Audits accuracy of data entry in the credentialing database and provides feedback to appropriate internal and external customers. This position requires in-depth knowledge of medical and allied health staff credentialing processes and requirements. Investigates issues of concern and conducts follow-up as needed, generates reports and presents findings to the Manager of Medical Staff Affairs (MSA) or Manager of Credentials Verification Organization (CVO). Serves as a subject matter expert to other PHS departments and facilities as it relates to the processing of initial and/or reappointment applications and/or privileging. Responsible for assigned duties and responsibilities to ensure compliance with the Medical Staff Bylaws, Rules/Regulations and/ or the daily work flow of the CVO. Works with the appropriate manager in the development of policies and procedures to meet regulatory and accreditation requirements. Manages special projects as assigned


How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.


Why Join Us

    Full Time - Exempt: Yes
  • Job is based Presbyterian Hospital
  • Work hours: Days
  • Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.


Ideal Candidate:

Associates Degree in medical staff services studies, or a related field preferred. Three to five years experience in medical staff affairs/credentialing, credentials verification organization, or related field preferred.

Qualifications
  • Associates Degree in medical staff services studies, or a related field preferred.
  • Three (3) to five (5) years experience in medical staff affairs/credentialing, credentials verification organization, or related field preferred.
  • Public relation skills required in order to be effective and behave in a professional manner when dealing with practitioners and customers.
  • Requires excellent time management and organizational skills in order to handle multiple projects simultaneously.
  • Certification or eligibility for certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred.

Education Essential: High School Diploma or GED

Responsibilities
  • Assists the Medical Director Department leadership in managing activities to ensure a coordinated effort to fulfill departmental responsibilities within its long-range plans and goals
  • Exercises discretion and independent judgment involving the comparison and the evaluation of possible courses of action related to meeting primary source verification and credentialing requirements.
  • Acts or reaches decisions independently after the various possibilities have been considered.
  • Investigates discrepancies in data submittal related to applications and privileging and formulates appropriate course of action.
  • Provides excellent customer service by responding to provider, client, and customer inquiries within specified timeframes, as required by the department
  • Maintains statistical information relative to the department s quality indicators
  • Responsible for orientation/training of new and current employees as it relates to departmental procedures, credentialing database, and daily work
  • Serves as a subject matter expert on appropriate national accreditation agencies and federal/state regulations pertaining to required credentialing processes
  • Maintains knowledge base of appropriate national accrediting agencies
Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.


Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.


Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.


About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.


Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.


Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.


AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

#NCS123

Maximum Offer for this position is up to
USD $28.36
Compensation Disclaimer
The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
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AA/EEO/VET/DISABLED/NMHRA. PHS is committed to ensuring a drug-free workplace.

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
High School or Equivalent
Required Experience
3 to 5 years
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