Provider Credentialing Jobs in Virginia (NOW HIRING)

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Primary Function/General Purpose of Position

Responsible for assigned Medical Staff Departments/Committee functions to ensure compliance with Medical Staff Bylaws, State and Federal requirements and accreditation standards. Facilitates all aspects of credentialing and privileging, to include processing of initial and reappointment applications for the Bon Secours Mercy Health Richmond market. Actively seeks to promote and maintain a positive, professional, team-oriented and service conscious environment that contributes to the goals of the department and reflects the values of Bon Secours Mercy Health.

Essential Job Functions

• Coordinate the credentialing and privileging of physicians and Ancillary staff members.

• Maintains credentialing software database with provider information

• Maintains the confidentiality of highly sensitive information regarding the Medical Staff, proceedings, disciplinary actions, and other personal and professional information.

• Communicates effectively with outside agencies, as well as other departments, hospitals, insurance companies, as authorized, to obtain or share information regarding physician credentials or privileges.

• Interacts effectively with other departments to integrate quality of care issues into the credentialing process.

• Facilitates and attends, as assigned, medical staff department and annual meetings. Secures meeting rooms, arranges for catering and special equipment needs for above meetings.

• Records meeting minutes and recommendations accurately to substantiate action taken by departments or committees. Maintains and protects the confidential records of proceedings which may be required in subsequent internal investigations and/or legal disputes.

• Participates in the preparation and on-site Joint Commission and State licensure accreditation surveys.

• Maintain confidential filing system for all current and archived provider files.

• Provide telephone coverage for the department, with other medical staff office employees, responding to a variety of requested information or services.

• Provides current and accurate information on legal issues/requirements and pertinent regulatory standards using state, federal and regulatory guidelines.

• Notifies the Medical Staff of upcoming meetings, special events, and CME opportunities.

• Prepare ongoing reports and monitoring reappointment cycle to ensure compliance with regulatory requirements.

• Collects and analyzes credentialing information to identify potential quality of care of concern, generate reports and presents findings to Director to facilitate recommendations to the Department Chairs and the Credentials Committee.

• Interacts effectively with Quality Management, Care Management and Surgical Services to integrate quality of care issues into the reappointment process. Responsible for running reports and obtaining current surgical and inpatient logs and Quality data for all reappointments.

• Creates and distributes unassigned ER call schedules for departments. Works with the Emergency Department personnel, physicians and Department Chairs to settle disputes concerning ER call coverage for all departments.

Employment Qualifications

• Associates degree or Bachelors degree preferred. Will consider candidates with experience in medical staff services/credentialing or Certified Professional Medical Services Management (CPMSM) and/or Certified Provider Credentialing Specialists (CPCS) in lieu of degree.

• Three years of previous medical staff services/credentialing experience preferred.

• CPMSM and/or CPCS certification by the National Association Medical Staff Services (NAMSS) preferred.

• Skill and proficiency in applying principles, concepts, and techniques that are central to the medical staff services profession. Such proficiency is generally acquired through an equivalent combination of education and experience.

• Must have excellent organizational and communication skills, as well as effective meeting management skills.

• Ability to maintain composure and make sound decisions while responding to request, problems or complaints.

• Ability to sit for long periods, to review written files, to be attentive and alert at meetings.

• Willingness to work flexible hours to accommodate meeting times.

• Recent experience in a medical staff office preferred.

• Comprehensive understanding of medical terminology preferred.

• Knowledge of The Joint Commission standards for Medical Staff preferred.

Range:

Minimum:$22.02

Maximum: $33.04

Bon Secours is an equal opportunity employer.

As a Bon Secours associate, you're part of a Mission that matters. We support your well-being - personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)

• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts

• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders

• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

Department:

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health- Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.