Office/Credentialing Coordinator - FT - Days - Pho

DHR Health - US:TX:McAllen - Days

Summary

FLSA STATUS: ☐ Exempt ☒ Non-Exempt

MISSION STATEMENT:

Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.

VISION:

Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

POSITION SUMMARY

Works to promote and support the functions of DHR Physicians Health Plus (DHR PHO) and assist its members. Participates in activities to achieve all DHR PHO goals and requirements. Is the primary person responsible for all activities involved in coordinating, organizing and maintaining records of educational events for PHO members. Is the primary person responsible for sending monthly membership invoices. Provides support in data analysis for assigned projects, and DHR PHO credentialing as necessary including the processing of new physician applications within the PHO. Communicates and provides feedback to team members. Assists the PHO Director and PHO Supervisor as needed to achieve Department goals and deadlines. Performs general office work, including typing, preparation of confidential and special reports.

POSITION EDUCATION/ QUALIFICATIONS­

• Associate or Bachelor’s degree preferred.
• Minimum two (2) years of physician credentialing experience preferred.
• Three to five (3-5) years in physician office or healthcare environment preferred.
• Minimum three (3) years in practice management with knowledge of overall management of a medical clinic or healthcare environment preferred.
• Certification in medical office management preferred.
• Knowledge of general office procedures, including but not limited to filing and recordkeeping required.
• Computer skills required with knowledge of Microsoft Office Suite.
• Working knowledge of medical terminology preferred.
• Excellent customer service and interpersonal skills required.
• Good written and verbal communication skills required.
• Bilingual – English/Spanish required.

JOB KNOWLEDGE/EXPERIENCE­

• Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in helping to develop departmental services, standards and practices
• Works well with other departments in order to expedite PHO functions, programs and marketing of its benefits.
• Provides excellent customer service to all members of the PHO Members as well as their staff and hospital co-workers and patients, when the opportunity arises.
• Must be well organized for prioritization of responsibilities.
• Must be able to handle stress relative to rush projects and meeting deadlines. Must be able to work under pressure in a highly a productive office.
• Must be able to cope with interruptions, varying personalities and some irregular hours.
• Must possess organizational and communication skills.
• Must possess willingness to improve and take on additional responsibilities.

Responsibilities

POSITION RESPONSIBILITIES

• Is the primary person who handles all activities and duties relating to educational seminars for medical practice staff and other sponsored events including but not limited to the following:
• Assists Director with Educational Calendar as needed (adding/canceling/rescheduling events).
• Creates flyers for new webinars.
• Verifies by internet or phone call Practice Management Institute’s (PMI) on a daily basis and communicates this with Director. Makes necessary adjustments to the PHO Educational Calendar.
• Emails all PHO members’ managers information regarding upcoming educational courses/webinars and takes their reservations by phone or email. Follows up with confirmatory email prior to the event.
• Creates Excel worksheet for each educational program and maintains reservations current and accessible to other PHO team members.
• Secures the space at the venue, i.e. Conference Center or elsewhere when necessary and ascertains that seating is adequate for the expected number of participants.
• Assures all required equipment is available and working (Microphone, laptop, telephone and internet services) for all presentations .
• Plans meals with Director for luncheons and other meetings and prepares catering forms for Food and Nutrition Department as required, adjusting the quantity as necessary.
• Signs registrants in for educational programs and remains available for issues that may arise during the program.
• Verifies accuracy of invoices from Caterer and/or Food and Nutrition Department and prepares check/credit card request forms according to Hospital policy/procedure.
• Accomplishes Department and organization mission by completing related tasks with professionalism and courtesy.
• Works closely with Practice Management Institute (PMI) and other educational partners in receiving materials and rosters for educational courses and certifications.
• Maintains administrative workflow by developing consistent reporting procedures.
• Conducts follow-up reminders (fax, phone and by mail, if indicated) regarding attendance in educational programs and other events, as necessary.
• Maintains sign-in sheets, sends certificates, presentation handouts and other necessary documentation to participants.
• Maintains accurate records regarding participation in the educational programs and updates Educational Activity Reports in a timely and consistent manner.
• Assists in general mailings for the PHO to promote events and general mission of the PHO and to recruit new members.
• Is the primary person responsible for sending invoices and collecting membership dues.
• Sends monthly invoices to members in a timely manner and follows up as needed by phone, fax, email and mail as necessary.
• Communicates with Director on delinquent membership dues regularly and maintains log of delinquent accounts/membership dues.
• Completes check/credit card requests as directed by PHO Director for professional memberships, resources and trainings.
• As necessary assists with credentialing activities in accordance with established policies and procedures including but not limited to maintaining and verifying current Texas Licensures, DEA, DPS and malpractice insurance on all DHR PHO members.
• Identifies inconsistencies in credential files and performs corrective follow-up.
• Maintains confidential credentials files of all members of the DHR PHO
• Reviews new applications for completeness, prepares, and sends for records status of responses. Send follow - up requests when needed.
• Photocopies and scans documents for each provider file and for meetings as necessary.
• Obtains signatures on credentials forms and credentials files as needed.
• Copies records at Medical Staff Office as necessary
• Maintaining and verifying current Texas Licensures, DEA, DPS and Malpractice insurance on all DHR PHO members.
• Assists with sending, receiving and cataloguing Messenger Notices to PHO members as necessary.
• Maintains confidentiality of all records and issues handled in the DHR PHO office, including proceedings, discussions and Board meetings.
• Provides recommendations for Department goals, policies and procedures, and process improvements in areas that impact his/her duties.
• Performs site visits at physicians’ offices as assigned using the form developed by PHO Director and approved by Board.
• Has primary responsibility of management of Superior managed care contract. Updates participation rosters as necessary and sends updated rosters to MCO as well as troubleshoots issues for providers and staff.
• When necessary assists in conducting Managed Care Organization audits
• Follows up on medical office inquiries and concerns and questions and routes them to the appropriate PHO team member.
• Responsible for typing, faxing correspondence, reports etc as needed and required by the Department.
• Creates Inventory Log and Update inventory log as needed and orders needed supplies as needed
• Assists PHO Director and PHO Supervisor as necessary.
• Performs all other assigned duties.

Other information:

LINES OF REPSONSIBILITES:

(Chain-of-command)

• Manager → 2. Director

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC:

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA):

A. Essential Duties: Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:

Light/moderate lifting up to 20 lbs, from the floor to shoulder height.

Yes

Kneeling

Yes

Must be able to assist other employees with lifting more than 20 lbs.

Yes

Walking

Yes

Light/moderate carrying up to 20 lbs.

Yes

Standing/Squatting

Yes

Straight pulling

Yes

Sitting

Yes

Pulling hand over hand

Yes

Pushing

Yes

Repeated bending

Yes

Stooping/Bending

Yes

Reaching above shoulder

Yes

Climbing Stairs

Yes

Simple grasping

Yes

Climbing Ladders

No

Dual simultaneous grasping

Yes

Depth Perceptions needed

Yes

Ability to see

Yes

Identify Colors

Yes

Operating office equipment

Yes

Twisting

Yes

Operating mechanical equipment

Yes

Crawling

No

Ability to read and write

Yes

Ability to Count

Yes

Ability to hear verbal communication without aid

Yes

Operating Personal Vehicle

Yes

Ability to comprehend written/verbal communication

Yes

Other: Ability to deal with stress

Yes

OSHA Category

III

B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes: HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to “catch on” or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to “visualize” objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2