Credentialing Coordinator

Participates in departmental activities to ensure quality in conducting, maintaining, and communicating the medical and allied health professional staff credentialing, privileging, and primary source verification process. Serves as a resource of the department, and collaborates with other team members to advance the quality of practitioners and patient safety of the facility.

Responsibilities

Participates in departmental activities to ensure quality in conducting, maintaining, and communicating the medical and allied health professional staff credentialing, privileging, and primary source verification process. Serves as a resource of the department, and collaborates with other team members to advance the quality of practitioners and patient safety of the facility.; Determines practitioner eligibility for membership/participation, analyzes applications and supporting documents for accuracy and completeness, and obtains, researches, and evaluates information from primary sources; Monitors the initial and reappointment process for all Medical and Allied Health Professional staff to ensure appointments are processed in required timeframes and meet regulatory requirements; Collaborates with various departments and key stakeholders to ensure all policies and standards are met; In collaboration with management, reviews and assesses departmental functions and services to identify areas for improvement and implement changes as needed; Other duties as assigned

Requirements

Associate's degree in business or healthcare related field and 2 years of medical administrative experience required; Or equivalent combination of education and experience; Fluent English language skills (oral and written) required; Proficiency in MS Office (e.g. Word, Excel, and PowerPoint), email, internet required

Nice to have

1 year of medical credentialing and/or payer enrollment experience preferred; Knowledge of and experience with Joint Commission, CMS, and NCQA Regulations related to medical staff services and Commercial Payers Credentialing preferred; Knowledge of and experience with database applications preferred; Exceptional interpersonal and communication skills preferred; Ability to develop and maintain relationships with a variety of key stakeholders across the organization preferred; Certified Medical Professional Services Management (CPMSM) upon hire preferred; Certified Provider Credentialing Specialist (CPCS) upon hire preferred