Medical Staff Credentialing Specialist - Full Time - Day Jobs in Hackensack at Hackensack Meridian Health

Overview

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

Come join our Amazing team here at Hackensack Meridian Health! We offer EXCELLENT benefits, Scheduling Flexibility, Tuition Reimbursement, Employee Discounts and much more!!!

The Medical Staff Office Credentialing Specialist is responsible for reviewing Medical Staff regulatory compliance with Centers for Medicare and Medicaid, NJ Department of Health guidelines, and The Joint Commission standards, as well as adherence to the Medical and Dental Staff Bylaws, Rules and Regulations, and Policies.

Responsibilities

A day in the life of a Medical Staff Office Credentialing Specialist at Hackensack Meridian Health includes:

• Monitors the initial appointment and reappointment process for the Medical Staff ensuring compliance with regulatory bodies (The Joint Commission, CMS, federal and state), as well as the Medical Staff Constitution and Bylaws and Rules and Regulations.
• Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
• Obtains supporting documentation for the applicant, such as, board certification verification, NPDB report, license verification, OIG report, GSA report, background check report.
• Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
• Conduct the pre-application process ensuring that applicants meet criteria and have been approved by the Department Chair prior to the CVO sending an application.
• Creates list of providers to be reappointed and sends to the Department Chair for approval. If approved, the CVO will send an reappointment application. If not approved will send certified mail informing the provider they will no longer be on staff, will submit Doctor Master to IT and remove membership and privileges from the medical staff database.
• Collect facility-specific application fees.
• Works closely with Department Chairs, administrators, physicians and applicants to facilitate resolution of credentialing and reappointment issues and concerns.
• Meets with Department Chairs and/or Division Chiefs to review applications and relevant documents for review and approval prior to presentation to the Credentials Committee.
• Prepares credentials file for presentation to the Credentials Committee, flagging any issues the Committee and/or Chairman may need to be alerted to.
• Serves as facilitator for the Credentials Committee, meeting with the committee chair to review agenda issues prior to meeting.
• Processes applicant additional privileges for review, ensuring compliance and obtaining case logs and other relevant documentation.
• Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
• Utilizes the medical staff credentialing database, optimizing efficiency, and performs query, report and document generation.
• Processes all actions following approval by the Board of Trustees sending Board approval letters to applicants and uploading letters into the medical staff database.
• Processes resignations, leaves of absence (and returns), department and status change requests, obtaining memo from department chair and bringing the request to the Credentials Committee, the MEC and the Board for approval
• Processes requests for change of collaborating/supervising physician obtaining department chair approval and bringing the request to the Credentials Committee, the MEC and the Board for approval.
• Processes temporary privileges for providers, obtaining signatures from the CMO and President of the Medical Staff, sending notification of temporary privileges to the applicant, their department, Administration, Human Resources, Risk Management, DTS.
• Assist applicants and their departments with leaves of absence and resignations, obtaining memo from department chairs and bringing requests to the Credentials Committee, the MEC and the Board for approval.
• Completes and submits Doctor Masters for resignations and Leaves of Absence.
• Submits EPIC access requests to DTS for credentialed providers.
• Notifies applicants if privileges are not recommended requesting that they formally withdraw the request or provide additional information as needed.
• Works with Risk Management providing packet of information for employed providers to receive malpractice insurance and collecting the malpractice facesheet from Risk Management once insurance is obtained.
• Covers for other Medical Staff Credentialing Specialists as needed.
• Removal of privileges process for employed/contracted providers.
• Works with the Security Department to obtain ID badges for non employed providers.
• Assist with numerous physician social and administrative functions hosted by the medical center.
• Assists with physician voting activities that includes, but is not limited to, Castle Connolly Top Doctors, Castle Connolly Top Hospitals, US News and World Report Top Hospitals, New Jersey Monthly Top Doctors, and others as needed.
• Actively participates in the efficient operation of the department, including answering the Medical Staff Office phone as needed.
• Perform all other work related duties as assigned.

Qualifications

Education, Knowledge, Skills, and Abilities Required:

• Two years credentialing experience in a Medical Staff Office with knowledge of medical credentialing and privileging procedures and standards or 5 years working in a hospital setting.
• Demonstrates reliability, tactfulness, honesty and discretion.
• Demonstrates attention to detail and is able to prioritize multiple tasks.
• Adapts to work schedules and frequent interruptions by demonstrating the ability to be flexible.
• Demonstrates exemplary organizational skills while setting appropriate priorities.
• Ability to communicate effectively, both orally and in writing.
• Demonstrates exemplary communication skills.
• Exemplifies excellent customer service skills.
• Demonstrates critical thinking and problem solving skills.
• Proficient in Google Workspace.

Education, Knowledge, Skills, and Abilities Preferred:

• Bachelor’s Degree
• NAMSS certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS)
• Knowledge of medical staff database program

HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER

All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.

Our Network

Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility

As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.