Credentials Coordinator-Medical Staff Services-West 57th Street

Job Description

Strength Through Diversity

Ground breaking science. Advancing medicine. Healing made personal. 

 

Medical Staff Services Req # 81648

Credentials Coordinator
 

Responsible for verifying the identity and qualifications of medical staff personnel to ensure each practitioner meets the requirements of the credentialing process and policies of the Mount Sinai Hospital and the Mount Sinai School of Medicine. Coordinates all functions related to credentialing and re-credentialing verification of the hospital’s medical staff. Responsible for coordination of all functions related to the appointment, reappointment of individuals to the department and related managed care plans.

 

Roles & Responsibilities:

  • Acts as customer service liaison and leads the credentialing process with medical staff personnel, department representatives, licensing agencies and insurance carriers.
  • Assesses and prioritizes Medical Staff appointments and backlog.
  • Evaluates applicants’ credentials in accordance in order to ensure compliance with medical staff by-laws and other regulatory bodies.
  • Develops and delivers management process metrics to medical staff management and its customers.
  • May act as team lead and may participate in probationary and annual performance evaluations.
  • Coordinates and administers the credentialing process with departmental representatives. Coordinates procurement of DE, licensure and malpractice information. Originates or collects and maintains appropriate records.
  • Maintains systems to identify (and disseminate to others) medical staff members and their credentialing status with payors. Prepares and maintains other related records and reports.             
  • Ensures timely and accurate processing of initial credentialing and re-credentialing of assigned providers.
  • Complies with complex and differentiated regulatory agency and insurance carrier requirements in order to coordinate the proper and timely enrollment of assigned providers in numerous insurance plans.          
  • Meets all required deadlines for provider enrollment and responds to requests from carriers and other external entities requesting information related to assigned providers.
  • Maintains and manipulates several physician databases including generating various reports as requested by internal departments, MCO's, HMO's, PPO's, hospitals, etc., with manager approval.
  • Works with manager to create improvements in database format to maximize the efficiency and accuracy of information maintained in the database.
 
Requirements:
  • Bachelor’s degree or equivalent experience.
  • 3 years hospital credentialing experience minimum.
  • Knowledge of commonly-used concepts, practices, and procedures used in health care and physician credentialing.
  • NAMSS Certified Provider Credentialing Specialist (CPCS) preferred.
  • Advanced Microsoft Office skills (MS Word, Excel, Power Point).Experience with Cactus Software systems or similar credentialing system.
  

Strength Through Diversity

 

The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize medicine together.

 

We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care. 

 

Explore more about this opportunity and how you can help us write a new chapter in our story! 

 

Who We Are

 

Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.

 

Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.

 

The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation. 

 

EOE Minorities/Women/Disabled/Veterans

 

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