OverviewSaint Joseph Hospital is a 433-bed facility located in Lexington Kentucky. Founded in 1877 a small group of Sisters of Charity of Nazareth in Kentucky led by Sister Euphrasia Stafford began their health ministry. Their mission was to provide compassionate care to the poor and underserved – a tradition still carried out today. Saint Joseph Hospital primarily serves central and eastern Kentucky with a full range of services including distinguished awards for cardiology orthopedics and stroke care. CHI Saint Joseph Health supports 5000 active employees 8 hospitals specialty clinics and a Medical Group with more than 200 locations across Central and Eastern KY. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.ResponsibilitiesThe Centralized Verification Organization (CVO) provides credentialing services to multiple facilities within the CHI Saint Joseph Health System. The CVO Credentialing Coordinator is responsible for performing all duties related to sending, receiving, processing and collection of primary source verifications for initial and reappointment practitioner applications. The coordinator will establish and maintain electronic credential files for assigned practitioners and complete the data gathering process within established guidelines for turnaround time, accuracy, and in accordance with external requirements (accreditation, federal, and state). Exemplifies a culture of excellence, effective communication and collaboration, and customer service with CVO leadership and staff, internal and external customers, medical staff offices, providers, and clinical and administrative leaders within CHI Saint Joseph Health. Handles, with discretion, issues that are significant, complex, multidisciplinary, sensitive, and confidential. Possesses and/or develops a strong grasp of the medical staff operations and the cultures of each affiliated institution and works to find common ground. Works to develop an overall singular culture of excellence and efficiency market wide. The CVO Credentialing Coordinatorwill report to the CVO Manager.ESSENTIAL KEY JOB RESPONSIBILITIES
Application management and verification activities, preliminary analysis of application and verification information, and analyzing verification information, to include identifying red flag and/or adverse information and notifying CVO leadership
in accordance with CVO policies.
Maintain and update credentials file(s) (paper and/or electronic as applicable), timely, accurate, and complete database entries, and maintenance of electronic files, as required.
Identifying discrepancies in information and conducting follow-ups.
Appropriately and timely communicate with assigned medical staff offices.
Timely and accurately prepare credential files for audit and submission to assigned hospitals.
Compliance with standard turn-a-round times.
Assist with the development and implementation of credentialing and re-credentialing workflows to ensure efficient and effective alignment of processes and assists in the development or revision of credentialing related forms.
Responsible for responding to requests for provider credentialing information timely.
Maintain a working knowledge of relevant regulatory standards (i.e., TJC and NCQA), state and federal requirements, and applicable Medical Staff Bylaws.
Enter and maintain accurate provider data in the organization credentialing database.
Assists with other tasks as needed during times of heavy volume or shortage of staff.
Participation in special project teams as assigned.
QualificationsRequired Education:
High School Diploma or GED
Required Licensure and Certifications:
Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional Medical Services Management (CMPMS) required upon eligibility.
Required Minimum Knowledge, Skills and Abilities:
Knowledge of TJC, CMS, State and Federal standards; Ability to interact with a variety of professional personalities and handle sensitive situations and information with tact, diplomacy, and confidentiality; Ability to manage multiple tasks concurrently, and select and utilize resources available effectively to maximize productivity; Possess critical thinking skills to resolve complex issues that may outstretch to other facilities and markets. Excellent communication skills are required in working with the providers, practice staff, internal teams, and leadership as the point of contact for the facility. Ability to work independently, dealing effectively with a variety of tasks, exercising good professional judgment, integrity and tact. Experience with Microsoft Word, Excel, and Website applications. Ability to work flexible hours as needed to accomplish the demands of the position and the related workload.
PREFERRED Qualifications:
Previous experience in medical staff services position desired.
Pay Range$18.74 - $25.77 /hourWe are an equal opportunity/affirmative action employer.
