Quality Controls Assistants / Trainees (Male)
Jafferjee Brothers Exports (Pvt) Ltd
The m&p correspondence credentialing specialist is responsible for securing hospital privileges for initial and reappointment telespecialists physicians each monthThe m&p correspondence specialists must maintain communication with the mso and physician, to ensure hospital applications are completed within the appropriate time frameThe m&p correspondence credentialing specialists will ensure all physician information is complete and accurate and all appropriate documents are maintained and current within md staffThe m&p credentialing specialist also ensures that the management team is made aware of any potential issues during any part of the processes.
Essential duties and responsibilities:
Maintain current knowledge about the credentialing department’s policies and procedures, regulatory requirements and applicable technologies.
Develop and maintain professional relationships with key customers both internal and external.
Collaborate with other members of the m&p team and the management team, to ensure high priority physicians and new hospitals credentialing are completed timely.
Communicate with the mso and the physician to ensure all pending elements needed to process the physician’s applications is received.
Ability to communicate effectively and diplomatically within a multi-functional team.
Follow-up on any missing elements needed by the mso, in order to complete the physician’s credentialing (peer references, education verification, hospital affiliations, documents needed from the physician, oppe/fppe, generate case logs from telecare, etc.)
Ensure appropriate follow-up is conducted, according to the external credentialing process.
Ensure all files in full application submitted to facility (fastf) status are worked based on the physician’s anticipate start date.
Responsible for ensuring new providers obtain privileges in at least 1 high volume hospital, for the provider to be considered successfully onboarded ( reference the new physician/new process credentialing and licensing process).
Responsible for ensuring the full application sent to facility (fastf) inventory is not greater than 15% past due.
Collaborate with the mso and the physician to ensure hospital interviews and drug tests are scheduled and completed.
Submit application fees & dues to accounting, when requested by management.
Responsible for securing at least 50 hospital privileges each month.
Responsible for maintaining a monthly quality audit score of 80% or above.
Document all required follow-up, based on the external credentialing process, and any additional follow-up outside of the required time frame in md-staff.
Escalate any non-response from the mso or physician to management team, as directed in the external credentialing process.
Communicate with licensing team for license status updates, in order to provide licensing updates to the mso, for providers in license pending verification complete (lpvc) status.
Evaluate providers in verification complete awaiting approval (vcaa) status, with tentative approval dates, to confirm those providers were approved for privileges.
Communicate with the clinical onboarding and technical manager for any facility systems training needed for the physicians (epic training)
Ensure departmental guidelines are followed to support all contracted hospital privileges and procedures
Updates md staff with any status changes and updates during the hospital credentialing process
Makes leadership aware of any potential derogatory issues identified during the credentialing process and works in collaboration with practitioner to document/resolve the issue
May be called upon to participate in meetings, to discuss a physician’s credentialing progress.
Other duties as assigned
High school diploma or equivalent
Medical office credentialing, enrollment, or licensing experience required
Md staff experience preferred
Experience with credentialing accreditation by joint commission or national committee for quality assurance preferred
Microsoft office suite
Certificates and licenses:
Certified provider external credentialing specialist (cpcs) through national association of medical staff services a plus