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.

• Maintains strict privacy and confidentiality at all times.

Clinical Competency Evaluations

If requested, participates in FPPE, OPPE, and FPPE for cause and conducts 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 decision‑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 School Education 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)

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