Credentialing Coordinator Job at University of Maryland Medical System

University of Maryland Medical System Largo, MD 20774

Company Description


THE MEDICAL HEART OF MARYLAND

Treating over 330,000 patients every year, the University of Maryland Medical Center is at the vital core of Maryland's health care system and community. We're known for our prestigious expertise in innovative research and education, along with the talented staff and advanced centers that make it all possible. The R Adams Cowley Shock Trauma Center, the world's first center dedicated to trauma, treats more than 7,500 critically injured patients a year with an incredible 97 percent survival rate. We also have one of the nation's largest kidney and pancreas transplant programs at The Joseph and Corinne Schwartz Division of Transplantation, home to Maryland's first steroid-free protocol and pancreas/kidney transplant. From our National Cancer Institute-designated UM Marlene and Stewart Greenebaum Cancer Center to The University of Maryland's Children's Hospital, one of the largest pediatric centers in the state, we are dedicated to saving and transforming lives.


Job Description


Principal Duties:

  • Coordinates UMCAP Medical/AHP Staff credentialing (initial and reappointment applications) - from receipt, to presentation to facilities for review/approval - verifying all background information, performing gap analysis, performing required primary source verifications of information on practitioner (verifying education, training, experience and competence), analyzing information obtained to ensure that membership and privilege requirements are met, within established timeframes.
  • Partners with Medical Staff Office personnel at all UMCAP facilities to ensure an integrated, timely and consistent product, with the goal of ensuring regulatory and Bylaws requirements are met, and that practitioners do not have a gap in privileges.
  • Collaborates with practitioners and/or contract and practice group contacts regarding status of applications, credentialing issues, pending expirations or expirations of required licensure and certifications, or questions and to ensure timely credentialing.
  • Collects and analyzes documents, data and verifications, and prepares reports by monitoring data published by Maryland licensing boards, FSMB, OIG and NPDB and other applicable sources, screening for any adverse actions.
  • Manages continuous credentialing process by collecting and analyzing documents and performing primary source verifications of medical malpractice insurance, licenses, prescriptive licenses, and other required certifications for membership and specific privileges.
  • Maintains credential files in required format to meet requirements of Joint Commission, CMS and for legal presentations.
  • Is responsible for organization of, and completion of, specific projects as required to meet new regulatory requirements and/or system changes.
  • Maintains a working knowledge of Medical Staff Bylaws of client facilities.
  • Maintains credentialing compliance with the accrediting and regulatory agencies (i.e., Joint Commission) while developing and maintaining a working knowledge of the regulations.
  • Is proactive regarding participation in available educational opportunities in the credentialing field. 1
  • Develops and maintains personal work processes that are cohesive with credentialing

Customer Service:

  • Greets customers in courteous, friendly, respectful and professional manner at all times, including maintaining eye contact when appropriate.
  • Follows communication protocols to both internal and external customers, including introducing him/herself with job title and experience, asking open ended questions, such as “How may I be of help to you?” using the customer’s name as soon as it is learned.
  • Responds promptly and appropriately to customer questions/concerns/complaints and attempts immediate resolution.
  • Keeps customer’s information confidential, including public places such as elevators or the cafeteria.
  • Provides assistance and offers help immediately, including finding someone else to meet the request, if unable to do so him/herself. Introduce other staff to customers when a hand-off occurs and explain that the person will provide excellent service.
  • Demonstrates commitment to excellent service recovery when a customer’s expectations have not been met.
  • Commitment to Co-Workers:
  • Offers assistance to colleagues and other departments when needed.
  • Takes responsibility for solving problems regardless of origin; completes assignments, and respects deadlines
  • Resolves conflict directly with colleagues and seeks assistance from others if the issue cannot be resolved. Refrains from criticism in public.
  • Mindful and respectful of others’ time and schedules. Attends meetings on time and communicates any absences.
  • Provides co-workers with a status report for continuity of workflow when planning to be out of the office, off the unit, or away from the department

Qualifications


Education Requirement:

  • High school Diploma required
  • Associates’ Degree in Healthcare Administration or related field preferred
  • One year of experience in a healthcare setting working with physicians, mid-level providers and office staff addressing coding and billing matters required.
  • Basic knowledge and working experience with Medical Terminology

Additional Information


All your information will be kept confidential according to EEO guidelines.




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