Medical Staff Services Coordinator
Description
The Medical Staff Services Coordinator plays an integral role within Medical Staff Services at Nashville General Hospital. The Medical Staff Coordinator will be involved in all aspects of the Medical Staff Services Department ranging from routine clerical tasks to complex projects requiring the ability to work independently, emotional intelligence and analytical skills. The successful candidate will have a proven track record of being dependable, self-motivated and effectively communicating with all levels of the organization.
This role serves as a progressive career role, offering career progression within Medical Staff Services. Advancement opportunities exist for the selected candidate to move into the role of Director of Medical Staff Services, where responsibilities include directing overall Medical Staff Services department, including policy and accreditation coordination, monitoring compliance with regulatory requirements, supporting all committee functions, including Bylaws Revision Committee, and Provider Wellness. The successful candidate will develop expertise regarding privilege form creation, policies development, and project management. Additionally, this role will be responsible for oversight of credentialing, privileging, and payer enrollment processes. The Director of Medical Staff Services collaborates with various stakeholders across the organization to accomplish hospital and department initiatives.
The selected candidate will be responsible for the coordinator duties as outlined below and will immediately enter into a succession planning process where they will train under the direction of the current department leadership.
Credentialing and Privileging
- Processes temporary privileges according to the Medical Staff Credentialing Policy, maintains detailed records about appointment timeframes and demographics
- Works closely with service line leaders to understand needs and schedules
- Works closely and professionally with the CVO to aid in the timely appointment, reappointment and addition of privilege processes
- Reviews practitioner’s privilege requests to verify that they meet established criteria, are within their scope of practice, and are presented accurately and in a prompt fashion to the Credentials Committee, Medical Executive Committee and the Board as directed
Payer Enrollment
- Leads payer enrollment for new practice locations and entities in a professional and timely manner
- Completes and processes payer enrollment applications for Providers for Medicare and Medicaid and submits required information for delegated credentialing for the remaining insurance carriers, aligned with PHO policies and procedures
- Completes timely follow up on all applications
- Prepares and presents material for routine audits for delegated credentialing
- Maintains providers profiles and NPI’s, CAQH and internal spreadsheets
- Monitor and maintain current documents (licenses, malpractice insurance)
- Maintain confidentiality of all providers information
- Works in conjunction with revenue cycle
General Routine Duties
- Ability to represent the Medical Staff Services and Nashville General Hospital in a positive and professional manner, understands and engages in the NGH philosophy of “managing up” across all levels of the organization
- Assists NGH leaders by coordinating medical staff support functions for the Medical Staff organization as outlined in the entity Medical Staff Bylaws and policies
- Supports all providers and external customers with finding solutions to concerns, and acts as a liaison between the providers and other hospital departments (IT, security, HR, administration)
- Coordinates and completes special projects promptly, appropriately prioritizes all tasks so that deadlines are met with continued focus on quality, and keeps all stakeholders apprised of any critical or major situations
- Maintains schedule for reviewing policies and procedures, and assists in policy revision process
- Assists in facilitating educational programs following ACCME accreditation guidelines
- Coordinates and maintains accurate on-call schedules for Emergency Department coverage, and a creates on-call schedules per contractual obligations and department rules and regulations
- Conducts physician onboarding to include processing paperwork needed for IT access, paperwork needed for badge, and physician orientation for all practitioners, residents and students as needed
- Conducts ID verification per the Medical Staff Credentialing Policy for all new Medical Staff members and privileged providers
- Coordinates all Medical Staff meetings, including General Medical Staff meetings, and responsible for scheduling room, catering requests, preparing attendance sheets, and minutes
- Participates in cross-training of new employees as needed to support department initiatives
- Develops procedures and policies in collaboration with Director, Medical Staff Services to improve department workflows and functionality.
Other related duties as assigned
Education & Experience
Minimum Requirements:
- Associate Degree in Business or Healthcare or equivalent combined professional training and experience
- Two years of experience in Medical Staff Services as a Credentialing Specialist or Medical Staff Coordinator
- In-depth knowledge of credentialing principles, processes, and standards, including NCQA, Joint Commission, and CMS requirements.
- Strong analytical skills with the ability to interpret complex regulations and accreditation standards.
- Expert level proficiency with Excel, Outlook and Word
- Ability to work well in a team environment
- Ability to triage priorities and handle conflict in a reasonable fashion with demonstrated time management skills
- Project management skills needed to take lead role in new initiatives
- Excellent communication skills, both written and verbal
- Dependable with positive, service-oriented attitude
- Proven ability to multitask with excellent diligence
- NAMSS Certification or Dual Certification (CPCS or CPMSM) or actively pursuing certification with success within one year from hire date required
Preferred Requirements:
- Bachelor’s degree in business or healthcare administration
- Three years of experience in Medical Staff Services payer enrollment and credentialing
- Demonstrated, expert level experience with Microsoft Office
- Tri-Certification (CPMSM, CPCS, CPES) through the National Association of Medical Staff Services (NAMSS)
Hours: Monday – Friday 8:00 am – 4:30 pm, with flexibility for early morning and evening meetings. May require travel to local offsite locations
About Nashville General Hospital
Nashville General Hospital (NGH) is Nashville’s original community- based hospital. Joint Commission accredited, NGH readily accommodates a wide range of needs from emergency services and acute care to ancillary and ambulatory services. NGH continues to maintain its strong commitment to the healthcare needs of Nashville and Davidson County underserved, while also providing care to all segments of the community.
Our benefits include:
- Medical, Dental, and Vision Insurance within first 31 days of employment
- Programs to reduce share of deductible and total out-of-pocket expenses
- Metro Health Incentive Program - Access to high quality healthcare without incurring out-of-pocket expenses
- Short and Long-Term Disability - up to 60% of eligible weekly pay
- Life Insurance - Metro provides you with basic life and AD&D coverage equal to $50,000 ($32,500 if you are age 65 or older), at no cost to you.
- 401K Retirement Plan - eligible up to IRS max limits and includes company contribution
- Shift and Weekend Differential Pay Offered on Nights and Weekends
- Tuition Reimbursement for employee and dependents
- 12 paid holidays - any holiday worked is another holiday banked
- Flexible Spending Accounts
- Free Parking for all employees
Join our team at Nashville General Hospital. Apply today!
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