About Us:

TeleSpecialists is a rapidly growing national telemedicine company seeking the right talent to join our team. We provide emergent and routine neurology and psychiatry services in over 300 hospitals across the country and continuing to expand services. We are seeking the right talent to join our team and help us with our mission of impacting patients, providing timely high-quality care to patients, and transforming the future of healthcare. We have an innovative and entrepreneurial culture that provides the opportunity for personal and professional growth.

TeleSpecialists Offers:

• A great culture with a team environment
• A fun, diverse work environment
• A rapidly growing company with career advancement opportunities
• Excellent Benefits
  • Medical, Dental and Vision benefits
  • 401k match
  • Paid Vacation
  • Remote workdays
  • Leadership Training
  • Mentorship Program
  • Tuition Reimbursement

About the Role:

The Regulatory Compliance and Quality Control Coordinator is responsible for the quality auditing for the Internal Credentialing, Licensing, Payor Enrollment, and External Credentialing teams. The Regulatory Compliance and Quality Control Coordinator also ensures that the management team is made aware of any potential compliance issues with all process as well as ensure the Credentialing and Licensing Department is in compliance with all regulatory requirements.

Essential Duties and Responsibilities:

• Completes the quality audit of at least 100% of the Internal Credentialing files including Initial and Re-credentialing
• Completes the quality audit of at least 10% of work per month of the External Credentialing (Applications Team, Delegated Credentialing, and M&P Correspondence), and Enrollment members
• Completes the quality audit of at least 10% of work per month of the Licensing Team members
• Completes the quality audit of at least 10% of work per month of the Payor Enrollment members
• Assists in creation of Training Modules for all aspects of the Credentialing and Licensing Departments to ensure compliance with all regulatory bodies
• Train new hires on regulatory requirements Ensure departmental guidelines are followed to support all contracted hospital privileges and internal TeleSpecialists procedures
• Identify and analyze the physician information documented within MDStaff and applications to ensure accuracy
• Track the quality control process to promote compliance, process enhancement, and efficiency
• Makes leadership aware of any potential derogatory issues identified during the quality process and works in collaboration with the team to resolve identified issues
• Ensures Credentialing & Licensing division is in compliance with Joint Commission on Accreditation of Health Organizations (JCAHO)
• Ensures Credentialing & Licensing division is in compliance with National Committee for Quality Assurance (NCQA)
• Ensures Credentialing & Licensing division is in compliance with International Organization for Standardization (ISO)
• Works collaboratively with Internal Credentialing, External Credentialing, Licensing, and Payor Enrollment to ensure policies and procedures are current and accurate based on Regulatory requirements
• Compiles and documents all information needed for Regulatory Audits
• Conducts mock audits throughout the year to ensure department is in compliance with Regulatory agencies
• Participates in Regulatory Audits
• Other duties as assigned

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to interact with internal and external customers
• Flexible and adaptable in learning and understanding new technologies
• Highly analytical and detail-oriented with ability to demonstrate command of details and to articulate those details at a higher level.
• Strong written, oral and interpersonal communication skills
• Highly self-motivated, directed and proactive
• Keen attention to detail
• Ability to effectively prioritize and execute tasks in a high-pressure environment
• Able to communicate effectively within department and with members of interdisciplinary teams
• Ability to work independently and proactively in a fast-paced, dynamic environment
• Proven analytical and problem-solving abilities

Education/Experience:

• High School Diploma or equivalent
• Credentialing experience required
• Physician licensing experience preferred
• MD Staff Experience required
• Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance preferred

Computer Skills:

To perform this job successfully, an individual should have knowledge of:

• Microsoft Office Suite
• Credentialing Software

Certificates and Licenses:

Certified Provider Credentialing Specialist (CPCS) through National Association of Medical Staff Services a plus

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer
• Must be able to lift 15 pounds at times