Job Description

Position Details

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.

Work Hours per Biweekly Pay Period: 0.00

Shift :

Location : 1324 Lakeland Hills Blvd Lakeland, FL

Pay Rate : Min $21.36 Mid $26.70

Position Summary

The Credentials Coordinator is responsible to the Manager, Medical Staff Services and works in conjunction with the Credentialing Supervisor. The Credentials Coordinator performs a variety of functions necessary to credential and privilege an array of provider types in accordance with Joint Commission, Medicare Conditions of Participation, NCQA/AAAHC and other managed care contract requirements/guidelines and best practices. The Coordinator utilizes technology to initiate provider credentialing applications, evaluate submitted applications for completion, review case logs to ascertain competency and perform critical verifications in order to prepare applicant files for a final review by the Credentials Committee. They work with department chairs/chiefs for clarification, and communicates with applicants, credentialing contacts and other related professionals throughout the process through both verbal and written communication methods. The Coordinator will evaluate requests for privileges and use a blend of credentialing knowledge and clinical familiarity to determine if an applicant meets the requirements for all requested privileges. The Coordinator will communicate progress to internal and external customers and those involved in the onboarding process. The Coordinator should identify red flags and escalate as appropriate. They should identify opportunities for and contribute to the improvement of quality, safety and cost, as well as patient, customer, and employee satisfaction. Perform other related duties as assigned.

Position Responsibilities

People At The Heart Of All That We Do

• Fosters an inclusive and engaged environment through teamwork and collaboration.
• Ensures patients and families have the best possible experiences across the continuum of care.
• Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Safety And Performance Improvement

• Behaves in a mindful manner focused on self, patient, visitor, and team safety.
• Demonstrates accountability and commitment to quality work.
• Participates actively in process improvement and adoption of standard work.

Stewardship

• Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
• Knows and adheres to organizational and department policies and procedures.

Standard Work Duties: Credentials Coordinator

• Actively participates in team development, achieving dashboards, and in accomplishing department goals and objectives.
• Data entry for all applicants and reappointments into the CACTUS system.
• Demonstrate knowledge of all equipment and systems/technology necessary to complete duties and responsibilities. Maintain accurate up-to-date information in the CACTUS system.
• Maintain accurate up-to-date files for each practitioner. Maintain good working relationship with physicians and their office personnel. Maintain confidentiality and privacy.
• Prepare, proofread, copy and data entry of physician extender files. Complete quarterly report to supervisor for credentials committee.
• Prepare, verify information, and invoice for any outside facility that we manage data collection.
• Maintain current knowledge of office procedures, medical staff activities and department policies. Complete special projects as assigned.
• Organize job functions and work assignments to be able to effectively complete assignments within established time frames.
• Demonstrated knowledge of all equipment and systems/technology necessary to complete duties and responsibilities.
• Other related duties as assigned.

Competencies & Skills

Essential:

• Strong critical thinking skills.
• Proficiency with Microsoft Outlook, Excel Word and online faxing software with the ability to organize and manipulate data within Excel for the purpose of evaluation and reporting.
• Proficiency with Adobe Acrobat including the ability to create and manipulate PDF documents and forms.
• Ability to work independently and with a team. Effectively multitasks and handles complex and varying workloads and changing priorities in an efficient manner through the use of strong organizational and time management skills.
• Understanding of the credentialing and privileging process in an accredited, inpatient hospital setting to include the requirements of both external regulatory entities and internal approval processes.
• Familiarity with healthcare industry regulatory agencies such as CMS, Joint Commission, NCQA, URAC, AAAHCand AHCA. Works with external surveyors when needed for file audits.
• Knowledge of medical terminology, including basic anatomy and corresponding medical procedures as they appear on case logs. Ability to perform research as needed for new or unfamiliar procedures/terminology.
• Strong written and verbal communication skills, including the ability to effectively communicate complex information in a concise but professional manner.

Qualifications & Experience

Essential:

• High School or Equivalent

Nonessential:

• Associate Degree

Other information:

Experience Essential:

- 2 or more years of experience in a professional office setting.

- 1-3 years of healthcare credentialing or equivalent healthcare administrative experience.

- Understanding of Medical Staff industry practices.

Experience Preferred:

- 1 or more years of hospital medical staff office experience including applications and privileging.

- Proficiency with Cactus Credentialing Software.

- Current Certified Provider Credentialing Specialist (CPCS) Certification.

- OSHA Working Standards.

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