Credentialing Coordinator

San Antonio, TX 78209

6 to 6 months contract

$25- 30/hr ( flexiable)

M-F 8-5 Onsite

Job Summary/Description:

Under minimal supervision, the Credentialing Coordinator is responsible for timely facilitating the management and coordination of the complex credentialing and privileging process of physicians, mid-level Providers, research associates, professionals, and paraprofessional individuals across multiple facilities in and outside San Antonio, Texas. The Credentialing Coordinator will also assist in initiating and facilitating the Provider Enrollment process for billing. The Credentialing Coordinator initiates access for providers Epic and other software and ensures information is accurate and updated . The Credentialing Coordinator will maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications, as well as Professional Liability coverage for each Provider. The Credentialing Coordinator also tracks and ensures the completion of required continuing medical education courses/workshops. Due to the complexity, the Credentialing Coordinator must be a self-starter that is able to adapt, multi-task, and understand the intricate credentialing and enrollment needs depending on the provider's specialty. Mentors and provides guidance to lower level team members.

Job Duties/Responsibilities/Functions (including but not limited to):

1. Guide Provider through credentialing and re-credentialing process and ensure the completion of required documentation for and all facilities where the Provider delivers services. Works with Provider to prepare and submit Medicare & Medicaid applications to enrollment office.

2. Prepare all credentialing applications, develop, and provide documentation that are not supplied by the Provider, address any additional information or corrections requested.

3. Verify and track the proper credentialing and re-credentialing of physicians, professionals, and paraprofessional individuals within all facilities where the Provider has privileges.

4. Receive credentialing application and enter data into credentialing system.

5. Work with Provider to maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications for each Provider, generate monthly report of expiring credentials.

6. Ensure ongoing monitoring of performance between credentialing cycles, generate performance review documentation, share with department for completion, and notify external entities when a Provider has been suspended, if necessary.

7. Work with Departments to obtain proof of Professional Liability coverage.

8. May provide support and information needed for monthly credentialing committee meetings, provide report to the committee of initial and reappointments.

9. Notify Providers and departments of credentialing status and final result, email notice to department and provider, ensure credentialing system (currently MD Staff) is updated with final credentialing result.

10. Ensure website accurately reflects Provider's credentials once cleared.

11. Track and ensure the completion of required continuing medical education courses/workshops; provide documentation to outside entities according to requirements.

12. Conduct customer service tasks such as responding to Provider, applicants, administrators, and hospital inquiries, provide documents to physicians/office staff seeking copies.

13. Perform all other duties as assigned.

MINIMUM Education:

Associate's degree is required. Will accept experience in lieu of education.

MINIMUM EXPERIENCE:

Three (3) years administrative experience, preferably in the hospital or clinical field, is required.