Credentialing Coordinator

Department Overview

The Medical Staff Office (MSO) at Hillsboro Medical Center (HMC) oversees practitioner credentialing, privileging, and medical staff support functions to ensure compliance with regulatory and accreditation standards and promote safe, high-quality patient care. Partnering closely with physicians, advanced practice providers, hospital leaders, and regulatory agencies, the MSO manages the full practitioner lifecycle, maintains accurate records, and supports key medical staff committees. Working in the MSO means joining a detail driven, collaborative team that plays a critical role in patient safety and organizational integrity. The environment is fast paced, highly regulated with a strong emphasis on accuracy, confidentiality, and service excellence.

 

The Credentialing Coordinator is responsible for coordinating practitioner credentialing, reappointment,

privileging, and ongoing monitoring activities for members of the medical staff and allied health professionals. This position ensures compliance with hospital bylaws, accreditation standards, regulatory requirements, and

organizational policies while supporting quality patient care through accurate and timely credentialing processes.

Function/Duties of Position

• Processes applications for credentialing and privileging for both initial appointments and reappointments and/or privileging, as defined by established policies and procedures. This process requires detailed knowledge of legal, state, OHSU, DNV, TJC, and NCQA guidelines in assuring compliance with regulatory standards. Recognizes, investigates and validates discrepancies and adverse information obtained from the application, primary source verifications, or other sources. Regular communication with credentialing contacts is central to ensuring timely and accurate completion of the credentialing process.

• Organization and maintenance of practitioner credential files, which contain confidential peer review information. As applicable when processing practitioner applications, this position involves consistent and professional follow-up for outstanding applications, conducting primary source verification, obtaining clinical activity documentation, and other searches such as OIG, Opt-Out and NPDB for presentation to the Medical Executive Committee/Governing Board. The coordinator tracks status of responses, follows up on missing information, and obtains appropriate approvals to assure that the practitioners’ credentials and quality files are complete, accurate, and up to date. 

• May need to collaborate with physician leaders, Credentialing Supervisor, and the Medical Affairs Director to develop and maintain a facility-specific, criteria-based clinical privileging system in accordance with regulatory requirements, accreditation standards, and organizational policies.

• Maintenance of confidential computerized information in credentialing databases for all applications for appointments and reappointments, as well as any other processing such as additional privileges, temporary privileges, status changes and more. Detailed documentation during all steps in the credentialing process and updating and/or revising information in the database regarding credentialing daily from receipt of application to completion of processing is key.

• May be required to perform and coordinate meeting logistics, documentation preparation, and follow-up at Hillsboro Medical Center.

• Other Duties as Assigned

Required Qualifications

• High School Diploma or GED required AND

• 3 years medical staff credentialing experience in a healthcare or insurance provider setting; OR associate's degree and 3 years experience performing data collection or data analysis using complex database software systems; OR A combination of education and experience.

• Demonstrated software database experience (for efficient generation of letters and other correspondence, activity tracking and report production).

• Familiarity with legal, state, TJC and NCQA guidelines in assuring medical staff compliance with regulatory agencies.

Job Related Knowledge, Skills and Abilities (Competencies):

• Expresses thoughts clearly, concisely, and effectively both verbally and in writing. Ensures a free flow of information and communication upward, downward and across the organization by actively listening and encouraging the open expression of ideas and opinions.
• Displays a credible presence and positive image. Use appropriate protocol for professional and social situations.
• Organizes work, sets priorities, and determines short- or long-term goals and strategies to achieve them. Aligns communication, people, processes and resources to drive success.
• Establishes productive, cooperative relationships with subordinates, peers, management, and stakeholders both internal and external to the organization.
• Ability to understand laws, regulatory agency requirements and standards. Possess independent problem solving and decision-making abilities.
• Sensitivity to, and natural inclination in, dealing with highly confidential information and communication.
• Proficiency in word processing, computer system work, understanding of data and ability to interpret complex scenarios to assess possible actions and resolutions around credentialing and privileging. 
• Must be able to perform the essential functions of the position with or without accommodation

Preferred Qualifications

• Associate or bachelor’s Degree
• Previous experience in hospital medical staff credentialing and privileging is highly desirable.
• Experience using CredentialStream or similar credentialing software.
• Experience supporting medical staff committees. 
• CredentialStream credentialing database.
• Hospital credentialing/recredentialing
• Certified Provider Credentialing Specialist (CPCS), or
• Certified Professional Medical Services Management (CPMSM) 

Additional Details

This position is being recruited for an expectation for Monday-Friday coverage from 8:00am-4:30pm. Full-time remote position with regular interaction with physicians, advanced practice providers, healthcare leaders, and external agencies. Position requires frequent computer use, management of multiple priorities, strict attention to detail, and the ability to meet established deadlines in a fast-paced regulatory environment.

Why apply to OHSU?

We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact [email protected]