Medical Staff Coordinator

It's inspiring to work with a company where people truly BELIEVE in what they're doing!

When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!

Role:

The Medical Staff Services Coordinator is responsible for coordination and oversight of Medical Services staffing support. Works closely with Medical Staff leaders, Administration, CareNu Credentialing, Human Resources, and members of the Medical Staff regarding initial and subsequent credentialing packages as required for enrollment in Government-sponsored health plans, professional demographic tracking, collaborative practice agreements, and provider onboarding.

Qualifications:

• High School Diploma or GED required; College degree in business or health-related field preferred

• Minimum of one (1) year experience in Medical Staff credentialing within Hospital or Physician Practice setting, or applicable Medical Office experience

• Experience in healthcare credentialing and enrolling individual providers through PECOS, NPPES, CAQH, Managed Care Organization, commercial plans, and various clearinghouse portals like Navinet and Availity preferred.

• Excellent typing, organizational, and time management skills

• Expert working knowledge of a variety of software including word processing, excel and Smart Sheet development and management

• Well-developed communication (verbal and written including editing documents)

• Excellent interpersonal communication skills and the ability to empathize with others

• Possesses excellent judgment and the ability to maintain professional relationships and boundaries when working with internal and external clients, colleagues and organizations

• Ability to lead by example, adhering to the highest standards of professional work ethics and confidentiality

Competencies:

• Satisfactorily complete competency requirements for this position.

Responsibilities of all employees:

• Represent the Company professionally at all times through care delivered and/or services provided to all clients.

• Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.

• Comply with Company policies, procedures and standard practices.

• Observe the Company's health, safety and security practices.

• Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.

• Use resources in a fiscally responsible manner.

• Participate proactively in improving performance at the organizational, departmental and individual levels.

• Improve own professional knowledge and skill level.

• Advance electronic media skills.

• Support Company research and educational activities.

• Share expertise with co-workers both formally and informally.

• Participate in Quality Assessment Performance Improvement activities as appropriate for the position.

Job Responsibilities:

• Coordinate with Onboarding/Recruiting, CareNu, Medical Services Practice Manager, Human Resources, Medical Directors, and VP of Medical Services for the hiring of prospective new Medical Staff and new contracted providers

• Implement and maintain procedure to credential prospective new medical staff and re-credential existing medical staff for all entities within the Organization.

• Maintain current individual medical staff provider files to include all current necessary medical staff documentation and provide credentialing information in a timely manner

• Maintain and manage professional demographics, including practice location and COIs for all Medical Staff

• Track expiration date for the state DEA, professional license, Board Certification, and Malpractice insurance of individual providers

• Coordinate and maintain enterprise-wide Nurse Practitioner (APRN) collaborative agreement with each additional new medical staff member and on an annual basis.

• Enroll new providers and groups with government payors and coordinates, monitors, and maintain the revalidation process with government payers.

• Obtain, complete accurately, and timely submit enrollment applications and related documents and ensure provider collected information is current and accurate

• Complete regular follow up with the payors to ensure applications are being processed

• Maintain CMS Medicare, Medicaid, PECOS, NPPES, and CAQH tracking log to ensure all necessary portals logins are active and available

• Work with individual providers to ensure each provider's CAQH database files are updated timely according to the schedule published by CMS Medicare/ Medicaid regulations.

• Ensure termination of enrollment with government payers upon resignation or termination of providers

• As directed, provide updated demographic information with supporting documents to outside participants, such as CareNu and contracted billing entities

• Work closely with the Med Staff Leadership to ensure all individual providers are credentialed and recredentialed timely

• Coordinate with CareNu to follow up on provider commercial payer credentialing

• Identify potential onboarding issues or concerns; research, provides clarification, and facilitates problem resolution

• Responsible of collaborating and advising as appropriate to limit company legal liability and escalates non-compliance issues and concerns

• Identify trends and issues with the onboarding process flow; make improvement recommendations to department director.

• Perform other duties as assigned

This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.