To apply for this position please go to the St. Mary Mercy Livonia Hospital website: http://smhweb.trinity-health.org/departments/careers.shtml
POSITION DESCRIPTION
Job Title: Credentialing Specialist Department: Medical Staff Office Job Code: R01427 Revision Date: 12/18/15 Pay Grade: 313 Approved By: ______FLSA Status: Non-Exempt
POSITION PURPOSE Ensures the timely completion of an application for initial and/or recredentialing by assisting the applicant in submitting all documentation necessary to process the application. Performs a variety of credentialing tasks at the direction of the Credentialing Coordinators and the Director to complete the credentialing process for Saint Joseph Mercy Health System. This position is an integral part of the credentialing team and is responsible for following credentialing policies and procedures, hospital bylaws, department rules and regulations, medical staff policies; maintaining an accurate physician data base; collecting data; and participating in development and implementation of changes to the credentialing processes.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
1. Assists applicants in completing and submitting the application form and required documents for medical staff membership. Communicates regularly with applicants and departments to complete all requirements of the credentialing criteria within specified timeframes.
2. Prepares the completed credentials file for review by the appropriate department chair. Submits file for department recommendation following review with the Credentialing Coordinator.
3. Assists the Director and Credentialing Coordinator in preparing the Credentials Committee agenda packet, which includes documentation of all action to be performed by the Committee. Performs appropriate follow-up as requested by the Credentials Committee and/or governing boards.
- 1 – 4. Assists in the reappointment process; collecting required information, verifying information, and completing appropriate follow-up to complete the reappointment application.
5. Assists in daily data entry to ensure an accurate physician data base.
6. Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and external entities.
7. Maintains customer-focus attitude, rapport, and cooperative relationships. Approaches conflict in a constructive manner. Helps identify problems, offers solutions, and participates in their resolution.
8. Provides administrative assistance to the Credentialing Coordinators and Director.
9. Participates in professional development programs and professional organizations to grow in understanding of the various regulations and legislation of the health care industry as appropriate.
10. Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution.
11. Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to St. Joseph Mercy Health System. Discusses patient and hospital information only among appropriate personnel in appropriately private places.
12. Behaves in accordance with the Mission, Vision and Values of St. Joseph Mercy Health System.
13. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
DUTIES CURRENTLY PERFORMED BY THE CENTRAL VERIFICATION OFFICE
14. Contacts various primary sources to gather the required verifications to complete the background investigation via telephone, fax transmissions, mailings and Internet to ensure rapid completion of the application.
- 2 – 15. Prepares written documentation of all verifications including a summary of all verified references, citing specific quoted remarks, for each completed credentials file.
OTHER FUNCTIONS AND RESPONSIBILITIES
Performs other duties as assigned.
REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE
1. Two years of post high school education, training or experience. 2. One year of work experience in the health care environment and general knowledge of the health care industry including hospital settings, physician practices, and managed care organizations. 3. Knowledge and understanding of NCQA and JCAHO standards, NPDB guidelines, hospital policies and procedures, and general licensing regulations. 4. Knowledge and experience with database organization and management, report generating languages, PC's and proficiency in Windows-based word processing software.
REQUIRED SKILLS AND ABILITIES
1. Ability to effectively communicate both written and orally. 2. Professional and cooperative attitude and ability to function as a team member when working with others. 3. Ability to organize, prioritize, and assesses workload on an ongoing basis. 4. Detail-oriented to ensure accuracy of physician database and credentialing processes. 5. Ability to maintain flexibility and a positive attitude in a rapidly changing environment. 6. Analytical skills necessary to handle moderately complex administrative details. 7. Proficient Word or WordPerfect skills and well as understanding of data base structure. 8. Capability to work independently and seek assistance appropriately. 9. Ability to multitask.
- 3 – This document is intended to describe the generalized duties and responsibilities, the specialized job functions, and the essential requirements of this job. It is not intended to be an exhaustive statement of all supplemental duties, responsibilities, or non-essential requirements or reflect any accommodations made under the American’s with Disability Act, the Michigan Handicapper’s Act, or SJMHS’s Return to Work Program
PHYSICAL REQUIREMENTS AND WORK ENVIRONMENT
1. Check the frequency and number of hours a day the worker is required to do the following specific types of activities: ACTIVITY FREQUENCY N/A RARELY OCCASIONALLY FREQUENTLY CONTINUALLY 0-25% 25-50% 50-75% 75-100% a. Sitting X b. Walking X c. Standing X d. Bending X e. Squatting X f. Climbing X g. Kneeling X h. Twisting X i. Lifting X j. Pushing X
LIFTING X 0-15 lbs. 15-30 lbs. 30-45 lbs. Over 45 lbs (with mechanical assistance)
3. (a) Does the job require worker to reach or work above the shoulder? _X___Yes _____No _0-25%_Frequency (b) Reaching at or below shoulder level? _X___Yes _____No _0-25%_Frequency 4. Does the job involve exposures (e.g., fumes, chemicals, vibrations, humidity, temperature, dust, noise, etc.): __X___Yes _____No Describe: Minimal noise, dust, temperature, humidity. 5. Are there special visual (PC work) or auditory (Telephone work) requirements? _ X_Yes _____No Describe: Functional level to use PC and answer phones WORK ENVIRONMENT: a. Does the employee work near moving mechanical parts; in high, precarious places; and in outside weather conditions? ______Yes __X___No
- 4 – BLOOD/FLUID EXPOSURE RISK: (check the right category) N/A ______Category I: Tasks involve exposure to blood, fluids or tissue ______Category II: Usual tasks do not involve exposure to blood, body fluid, or tissues but job may require performing unplanned Category I tasks. __X____Category III: Tasks involve no exposure to blood, body fluids, or tissues. Category I tasks are not a condition of employment.
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