Beth Israel Deaconess Medical Center Credentialing Specialist (32hrs, Day) in Needham, Massachusetts
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Credentialing Specialist (32hrs, Day)
Department Description:Beth Israel Deaconess Hospital−Needham (BID−Needham) is a licensed 58-bed acute care community hospital. BID−Needham has served residents in Needham, Newton, Dedham, Dover, Medfield, Sherborn, Wellesley, Westwood and other surrounding communities for more than 100 years. The hospital has been recognized by several organizations for quality and safety, including the Gold Seal of Approval® from The Joint Commission and a first-place Accountable Care Compass Award from the Massachusetts Health & Hospital Association (MHA).
BID−Needham is part of Beth Israel Lahey Health, a new health care system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,000 physicians and 35,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.
BID Needham has had a direct affiliation with Beth Israel Deaconess Medical Center since 2000, facilitating the clinical integration of staff and resources in emergency medicine, hospital medicine (hospitalists), cardiology, radiology, orthopaedics, pathology, as well as many surgical services and oncology housed in the Beth Israel Deaconess Cancer Center and Surgical Pavilion.
Job Location:Needham, MA
Job Summary:Performs all functions necessary to ensure all new and reappointed Medical Staff are credentialed according to the guidelines established by the Medical Staff Bylaws, the Joint Commission, and State and Federal regulatory agencies.
Audit files returned from the CVO for accuracy and completeness according to Bylaws, Joint Commission, State and Federal guidelines. Ascertain any serious issues in need of further investigation. Follow up on information missing from returned files. Speak with providers directly to clarify information. Perform queries to access current license/malpractice verifications.
Enter Cactus/MEDITECH demographic and privileging information. Process dictation codes as applicable. Obtain Peer Review/reference documentation. Effectively communicate verbally and through written correspondence with all levels of providers, Chiefs of Service, Department Chairpersons and office managers and other individuals who are influential or are important to the hospital.
Obtain signatures from Chiefs of Service and Department Chairpersons for credentialing files and Delineation of Privileges. Assist Credentials Committee Chairperson to review files and follow up on issues. Prepare agenda, meeting materials, take minutes. Prepare BOT list after Committee meets. Prepare Welcome and Reappointment notification letters after BOT approval.
Send application requests to MedVentive. Process temporary privileges, resignations and category changes. Maintain Cactus and MEDITECH databases. Maintain provider files for completeness and updated information. File processed applications and prepare old files for storage. Process hospital verifications on a weekly basis. Sort mail and other correspondence.
High School diploma or GED required. Associate's degree preferred.
0-1 years related work experience required in Credentialing experience.
Strong oral, written communication skills and problem solving skills
Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
1-3 years of experience in acute hospital or HMO provider credentialing.
CPCS (Certified Provider Credentialing Specialist).
Decision Making:Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
Problem Solving:Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
Independence of Action:Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.
Written Communications:Ability to communicate clearly and effectively in written English with internal and external customers.
Oral Communications:Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.
Knowledge:Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.
Team Work:Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.
Customer Service:Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally