Job Opportunities API

Thank you for considering a career at Roper St. Francis Healthcare! Scheduled Weekly Hours: 40 Work Shift: Days (United States of America) This position will be remote, but will have on site responsibilities periodically for meetings and training at the Bon Secours St. Francis Hospital Campus, Charleston, SC. Primary Function/General Purpose of Position Credentialing   and Privileging The   Medical Staff Credentialing Coordinator   completes credentialing and   privileging   for physicians and allied health professionals, ensuring compliance with   CMS ,   The Joint Commission , and   South Carolina   regulations. Responsibilities include processing applications, completing   Primary Source Verification , and coordinating with Medical Staff Leadership and the Credentials Committee to support   timely   provider appointment and reappointment.   The role follows established workflows and bylaws while   maintaining   accuracy, communication, and strong customer service, and partners with Managed Care to ensure compliance with the RSFH Credentialing Plan. Essential Job Functions Responsible for Full Cycle Credentialing, Privileging, and (if applicable) Enrollment Processes • Processes and manages all medical staff and allied health credentialing applications for RSFH, including sending and tracking electronic applications and completing primary source verification of education, training, licensure, DEA, malpractice coverage, affiliations, references, and background checks. Ensures accuracy and compliance with accreditation and regulatory standards   including   The Joint Commission (TJC), National Committee for Quality Assurance (NCQA) (if applicable), Centers for Medicare & Medicaid Services (CMS)   and SC laws. • Conducts and   maintains   all credentialing and   privileging   activities, including   determining   initial eligibility,   identifying   and resolving discrepancies, verifying   expirable , and preparing practitioner-specific data for review by decision-making bodies. Manages initial and reappointment processes, privilege requests, and application   status   communication. • If applicable, handles payer enrollment for employed and contracted providers, processes electronic enrollment applications, updates provider data in the credentialing database, and communicates status updates to internal stakeholders.   Requests   additional   documentation as needed. • Ensure   files and documents are complete and ready for review by the IPN Leader/Credentialing Reviewer, Credential Committees, and Medical Staff Leaders. Collaborates with credentialing auditors to correct deficiencies and completes workflows with accuracy. • Organizes and   maintains   provider data and files, ensuring   timely   processing of applications and meeting quality benchmarks for turnaround times, accuracy, and regulatory metrics.   Ensure   the provider database is updated with   accurate   information. • Follows all regulatory requirements related to primary source verification for medical staff and managed care compliance (if applicable). • Completes credentialing compliance checkpoints to ensure files are ready for review. • Maintains awareness of The Joint Commission (TJC), National Committee for Quality Assurance (NCQA) (if applicable), Centers for Medicare & Medicaid Services (CMS), and other regulatory guidelines through continuing education. • Demonstrates excellent professional communication skills when interacting with colleagues, providers, leadership, and others to collect missing information or resolve issues. • Responsible for distributing Board correspondence and notifying hospital departments of new medical staff members. • Attends Credentials Committee, CMEC, and other meetings as   required . • Provides administrative support to the Manager, Medical Staff Services. • M aintains strict privacy and confidentiality at all times . Clinical Competency Evaluations If requested,   p articipates   in FPPE, OPPE,   and FPPE for cause and   c onducts and   maintains   evaluations by preparing structured reports for   the IPN/Credentials Reviewer , and investigating discrepancies or adverse findings. Coordinates physician leader review of competency data to support informed evaluation and   d e cision ‑ making . Credentialing Databases/IT Applications: Responsible for maintaining current and precise database management and to assure the accuracy of all pertinent information as needed to provide reports, department mailing lists/labels, rosters and to guarantee that all practitioner’s privileges/scope of practice/agreements are renewed according to TJC and federal/state regulatory agency requirements and that there are no lapses in licensure and/or insurance coverage and Board certification. Collects current information on a regular basis from all members of the Professional Medical Staff.   May be requested to   processes   KEPRO acknowledgements,   340 B forms,   provider rosters, and other RSFH initiatives. Meeting Coordination & Minutes:   Coordinates agendas, gathers materials, prepares electronic packets, issues meeting notices, and transcribes and revises minutes as needed. Tracks   follow ‑ up   items,   maintains   department minutes and attendance records, and supports Chairs/designees with meeting preparation   as needed. Performance Improvement & Compliance:   Assists   continuous quality improvement by recommending updates to department policies and procedures,   assisting   with TJC accreditation preparation,   monitoring   compliance with standards, and reporting issues to the Manager of Medical Staff Services. Department Knowledge & Development:   Maintains current knowledge of Medical Staff Bylaws, Rules, and Regulations, and   participates   in staff meetings and professional development activities as assigned. Communication & Professionalism: Facilitates communication between Medical Staff Services and other departments by managing calls, relaying updates, and notifying essential departments of   provider   changes or medical staff issues. Additional Duties: Performs other responsibilities as assigned to support departmental operations and organizational needs. Licensing/Certification:   NAMSS certification (CPCS or CPMSM) is preferred at hire and   required   within five years if not already obtained. Long ‑ term RSFH Medical Staff Services employees (5+ years) are encouraged but not required to be certified. Membership   in   national, state, or local Medical Staff Services organizations is preferred. High   S chool   E ducation   or GED   required ; bachelor’s degree preferred. Work Experience: •   A minimum of two years of credentialing experience in a Medical Staff Office, Centralized Credentialing Organization, or managed care environment   required . Training • Credential stream  Credentialing software (preferred) Language • None Patient Population • Not applicable to this position Working Conditions • Periods of high stress and fluctuating workloads may occur. • May have periods of constant interruptions. • Prolonged periods of working alone. Physical Requirements   -   Mark selections with an "X": Physical Demands Frequency                                              0%                  1-33%                 34-66%                 67-100% Lifting/ Carrying (0-50 lbs.)                                                  x Lifting/ Carrying (50-100 lbs.)             x Push/ Pull (0-50 lbs.)                                                               x Push/ Pull (50-100 lbs.)                         x Stoop, Kneel                                            x Crawling                                                  x Climbing                                                     x Balance                                                      x Bending                                                     x Work Position Frequency                                               0%                  1-33%                 34-66%                 67-100% Sitting                                                                                                                                                           x Walking                                                                                  x Standing                                                                                     x Additional Physical Requirements/Hazards Physical Requirements • Hear alarms/telephone/audio recordings • Repetitive arm/hand movements • Finger Dexterity • Color Vision • Acuity – far • A cuity – near Hazards • Not applicable to this position Skill s • Medical Staff Credentialing • Data Collection • Data Entry • Healthcare Policies • Confidentiality • Flexibility • Managing Multiple Priorities • Attention to Detail • Critical Thinking • Accuracy • Teamwork • Conflict Resolution • Active Listening • Communication professionally with team,   providers   and other departments • Relationship building • Writing • Self-motivated • Accountability • Proof reading • Autonomy • Managing deadlines Roper St. Francis Healthcare is an equal opportunity employer. As a Roper St. Francis Healthcare teammate, you’re part of a Misson that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. What we offer • Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible) • Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts • Paid time off, parental and FMLA leave, and short- and long-term disability • Tuition assistance, professional development and continuing education support Benefits may vary based on the market and employment status. Department: Medical Staff Services - Roper St Francis Healthcare It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [email protected] .