Credentialing / MSO Coordinator

About us: For the past 85 years, Stephens County Hospital has been a trusted name in the community, striving for excellence and delivering professional and compassionate care. Our dedicated staff of approximately 475 employees has a heart for healthcare and realizes how precious the gift of good health can be.

Stephens County Hospital is a 96-bed acute care hospital located in Toccoa, Georgia. We are nestled in the beautiful foothills of Northeast Georgia where our family-oriented community offers many cultural and civic opportunities as well as numerous outdoor activities.

Stephens County Hospital is a member of the Georgia Hospital Association, American Hospital Association and Georgia Alliance of Community Hospitals. Stephens County Hospital is fully accredited by the Joint Commission, the nation’s premier healthcare monitoring agency.

Full Time - Day Shift

The Credentialing / MSO Coordinator is responsible for ensuring all regulatory and accreditation standards are followed for the credentialing and recredentialing of physicians and allied health professionals. Assisting with the review of inpatient and outpatient medical records for core measure compliance and ensuring timely submission of required reviews. Responsible for the contract system through completion, maintaining accurate and current documentation. Updating and maintaining physician call schedules. Coordinating resident physician rotations with internal departments and affiliated programs. Preparing agendas, reports, and supporting materials for monthly Medical Executive Committee meetings. Maintaining accurate medical staff records and providing administrative support for Medical Staff Office operations. Collaborating with physicians, department leaders, and administrative staff to ensure efficient coordination of medical staff activities.

Education:

Associate Degree in related field required.

Bachelor Degree preferred

Experience:

Ability to type 50 – 60 words per minute with 80% accuracy.

Personal computer experience with word processing and either spreadsheet or database experience required.

Duties and Responsibilities

Accepts and supports change in assignments without disruption in work/department.
Willing to alter, if possible, job procedures to accommodate the needs of others.
Willing to change scheduled work time as needed.
Volunteers to accept additional duties.
Works positively with others.
Supports manager/supervisor.
Acts to promote harmonious work relationships and contributes to effective teamwork in the department and hospital.
Completes assignments and routine job functions on time without reminders (to include annual health update, etc.)
Voluntarily assists others, or takes initiative to assist with department workload once own duties are completed.
Searches for ways to improve service delivery of his/her department and makes ideas known to Administration.
Volunteers regularly for CQI teams
Deals courteously and tactfully with others displaying understanding and concern: patients, visitors, co-workers, physicians, public-at-large, vendors.

Actively seeks out the opinion of customers.
Attends monthly staff meetings and offers constructive input.
Processes privilege requests per the time period specified in the Medical Staff Bylaws.
Assures privileges requested are currently available at SCH and are necessary.
Processes new applications by assessing, collecting and verifying information regarding current licensure, education and relevant training, experience, ability and current competence to perform the requested privilege(s).
Assures a comprehensive evaluation of the practitioner’s professional experience includes patient care, medical/clinical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism and systems based practices.
Assures education and relevant training is verified via an original source when possible according to Joint Commission standards. When not possible, utilizes only reliable secondary sources.
Assures that licenses are verified prior to granting of initial privileges, re-privileging and prior to license expiration
Acts as a liaison between the officers of the Medical Staff and Hospital Administrator in granting of privileges.
Assures credentialing information is maintained in a database in order to process applications on the appropriate reappointment date.
Maintains a database of DEA and malpractice insurance dates; contacts physicians and allied health professionals for updated information.
Circulates notices of new privileges granted to include necessary demographic and privileging information required by various departments.
Participates in The Joint Commission Survey Medical Staff Credentialing session each survey.
Compiles physician performance information for presentation to the Medical Executive Committee in July and December to substantiate ongoing professional practice evaluation.
Aggregates, analyzes and compares data to other peers in the same profession. Information is collected on abbreviation usage, unplanned trips to the OR, utilization statistics and patterns, obstetric data, postoperative complications, infections and core measure indicators.
Processes reappointment applications per the time period specified in the Medical Staff Bylaws.
Contacts other facilities for information to substantiate requests and competence for reappointment of low volume practitioners.
Reviews information gathered during credentialing/recredentialing process and discusses potential problem areas with QI Director and Chief of Staff.
Processes requests for physician/allied health professional references requested by other facilities.
Initiates and compiles physician practice indices in accordance with the reappointment process.
Assures compliance with The Joint Commission Medical Staff standards.
Maintains files of credentialing information in an organized manner.
Works with the Medical Director of CME to establish a calendar of programs.
Coordinates meals for programs with the dietary department and/or sponsoring agencies.
Maintains a complete and accurate record of attendees, evaluations and programs offered.
Coordinates logistics for programs.
Develops flyers/notices of inservices and distributes to physicians.
Attends the Surgical Service Committee each quarter with the Surgical Services Manager.
Develops the meeting agenda for the Surgical Service Committee in coordination with the Surgical Services Manager and Chief of Surgery.
Performs quarterly medical record reviews required for the Medical Staff performance improvement to include blood utilization/compliance, high risk/high volume procedures per criteria established by Surgery Service Committee, anesthesia cases to include conscious sedation and pre/post-operative diagnoses reviews.
Assures that actions discussed at the Surgery Service Committee are followed up on at the next meeting or coordinates follow up after the meeting.
Assures performance improvement data and core measure data is discussed at each Committee meeting.
Assists with the review of inpatient medical records for compliance with required core measures – pneumonia, congestive heart failure, acute MI and surgical care improvement project.
Insures that record reviews are in accordance with the Data Specification Manual instructions and pass validation audits by the Georgia Medical Care Foundation.
Assists with outpatient (ER and outpatient surgery) medical records for compliance with required core measures – chest pain/acute MI and surgical care improvement project.
Assures information from these reviews is entered in the CART program for submission to HERMES and QNET conduits.
Investigates, corrects and resubmits any data transmission errors.
Logs incident reports when received.
Assists in routing incident reports to appropriate individuals for investigation.
Works with managers to make sure incident investigations are completed in a timely manner.
Maintains a database of incident reports.
Compiles monthly summaries and routes to appropriate individuals.
Schedules meetings and reserves space as needed.
Sends meeting notices and agendas.
Assists with routing monthly calendars to appropriate individuals.
Assists with compiling and copying the necessary information for meetings.
Maintains attendance records of physicians.
Transcribes meeting minutes and correspondence.
Organizes and enters Surgical Case information in a manner that can be reviewed by the QI Director and the Medical Director of the Laboratory.
Performs quarterly data collection required for Medical Staff performance improvement.
Designs forms to accommodate the collection of information.
Designs databases and spreadsheets to facilitate the collection and reporting of information.
Types documents and correspondence for the department.
Maintains adequate supplies for the department.
Files information in an organized manner.
Routinely culls files of old information or information that can be condensed into another format.
Microfilms records.
Photocopies, faxes and routes mail.
Enters data into computer files on a routine basis.
Develops charts and graphs to provide information for Medical Staff.

Knowledge, Skills, and Abilities

Strong organizational and interpersonal skills
Ability to determine appropriate course of action in more complex situation
Ability to work independently, exercise creativity, and maintain a positive attitude
Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work
Ability to maintain confidentiality of all medical, financial, and legal information
Ability to complete work assignments accurately and in a timely manner
Ability to communicate effectively, with excellent verbal and written communication skills

Non-Essential Functions

Perform other duties as assigned or requested.

Professional Requirements

Adhere to dress code, appearance is neat and clean.
Complete annual education requirements.
Maintain patient confidentiality at all times.
Report to work on time and as scheduled.
Wear identification while on duty.
Maintain regulatory requirements, including all state, federal and local regulations.
Represent the organization in a positive and professional manner at all times.
Comply with all organizational policies and standards regarding ethical business practices.
Participate in performance improvement and continuous quality improvement activities.
Attend regular staff meetings and in-services as needed.

Physical Requirements and Environmental Conditions:

Ability to Hear (with/without aid) – able to hear alarms/telephone/ normal speaking voice/webinars (0-33%)
Ability to see – clarity of vision (both near and far) either corrected on non-corrected, ability to distinguish colors (34-66%)
Have good manual dexterity and eye-hand-foot coordination (34-66%)
Sitting – continuously within the shift (34-66%)
Standing – frequently within the shift (67-100%)
Walking – frequently within the shift (34-66%)
Climbing – occasionally within the shift (34-66%)
Bending/stooping – frequently within the shift (0-33%)
Twist at the waist – occasionally with the shift (0-33%)
Electrical hazards – frequently within the shift (0-33%%)
Lift/carry – 20lbs with assistance – occasionally within the shift (34-67%)
Reaching above the shoulders – frequently within the shift (34-67%)
Lift/carry – 50lbs with assistance – occasionally within the shift (1-33%)
Wet hazards (34-66%)

Stephens County Hospital is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition, carrier status or any other legally protected status

marie.culver@stephenscountyhospital.com