1.Performs the credentialing and privileging process in accordance with federal and state mandates as well as with criteria defined by Scotland Healthcare ‘s compliance policy, in a complete and accurate manner.
2.Tracks and follows up on physicians initial application/onboarding processes and reappointment application by performing primary source verification, preparing agency correspondence, and tracking responses within the organizations database
3.Works with necessary individuals- including physicians, other professional staff and their office to acquire necessary materials and information for provider certification and licensure
4.Serves as credentialing contact for employed physicians and advanced practice professionals. Monitors employed physicians and advanced practice professionals’ credentials including, but not limited to state licensure, board certification, and hospital affiliation status for timely renewal and renewal support.
5.Safeguards the integrity of privileged information and credential files in a professional, sensitive manner
6.Identifies sanctioned providers on state and federal disciplinary reports and initiates the requisite corrective processes to address cited violations
7.Quarries the Nation Practitioner Data Bank as needed, and does so in compliance with the Healthcare Quality Improvement Act (HCQIA)
8.Remains complaint with and knowledgeable of rules and regulations set forth by HIPAA, Joint Commission, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid Services, as well as state regulations and relays this information to the necessary parties to ensure ongoing compliance organization-wide
9.Serves as credentialing contact for employed physicians and advanced practice professionals. Monitors employed physicians and advanced practice professionals’ credentials including