Credentialing Coordinator

Company Description

Job Description

Ensures the timely completion of an application for initial and/or re-credentialing by assisting the applicant in submitting all documentation necessary to process the application. Performs a variety of credentialing tasks to complete the credentialing process for Government Medical Services. This position is an integral part of the credentialing team and is responsible for following credentialing policies and procedures, maintaining an accurate physician database, collecting data, and participating in the development and implementation of changes to the credentialing processes and Facilitate Credentialing/Privileging Committee meetings.

• Performs file audits and provides feedback on completed initial and reappointment credentialing files.
• Assists in daily data entry to ensure an accurate healthcare provider database.
• Communicates regularly with applicants to complete all requirements of the credentialing criteria within specified timeframes.
• Contact various primary sources to gather the required verifications to complete the background investigation via telephone, fax transmissions, mailings, and Internet to ensure rapid completion of the application.
• Prepares documentation of all verifications including a summary of all verified references for each completed credentials file.
• Assists in the reappointment process; collecting required information, verifying information, and completing appropriate follow-up to complete the reappointment application.
• Meets processing time thresholds consistently and with minimal error.
• Maintains a customer-focused attitude, good rapport, and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution. Tracks errors and complaints to assist with process improvement activities.
• Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner.
• Helps to identify problems, offer solutions, and participate in their resolution.
• Maintains the confidentiality of information acquired pertaining to patients, and physicians. Discusses patient and hospital information only among appropriate personnel in appropriately private places.
• Assumes responsibility for the performance of job duties in the safest possible manner, to ensure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
• Performs other duties as needed and assigned by the HQ Operations Manager.
• Maintains a working knowledge of applicable Federal, State, and local laws/regulations; the Government Medical Services and Compliance Program and Code of Conduct; as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Qualifications

• Must possess two years of post-high school education, training, or experience in medical credentialing and privileging. Associate degree in health administration or a related healthcare field preferred.
• One year of work experience in the healthcare environment and general knowledge of the healthcare industry including hospital settings, physician practices, and managed care organizations.
• Certified Provider Credentials Specialist (CPCS) preferred.
• OCN Credentialing experience. (preferred)
• Knowledge and understanding of NPDB guidelines, and general licensing regulations.
• Government Medical Service policies and procedures (preferred)
• Knowledge and experience with database organization and management, report-generating languages, PCs, and proficiency in Windows-based word processing software.
• Strong communication skills including the ability to correspond effectively, as well as verbally convey information clearly, listen actively, and consider varying viewpoints when making decisions. Strong statistical, analytical, and problem-solving skills. Ability and desire to provide quality service to others. Strong organizational skills and the ability to provide attention to detail and thoroughness. Ability to work autonomously and within a team environment. Must possess the ability to comply with Government Medical Service policies and procedures.

Required Competencies

• Ability to build and maintain effective working relationships and personal credibility.
• Excellent communication, consulting, and influencing skills.
• Self-starter: takes initiative and proactively communicates.
• Ability to work under pressure and meet deadlines.
• Collaborative approach working with HR colleagues, cross-functionally and among client groups
• Assertive, resilient, and resourceful
• Ability to deal with ambiguity and implement best practices in the absence of a policy or procedure.
• Effective listening skills: ability to assess a situation and propose reasonable solutions.
• Strong interpersonal skills to work effectively with all levels of leadership, employees, and peers.

Required Languages (Brief description of the language skills needed to perform the job)

• English required.

This is a hybrid position

Additional Information

Pay range is based on several factors and may vary in addition to a full range of medical, financial, and/or other benefits. Final salary and offer will be determined by the applicant’s background, experience, skills, internal equity, and alignment with geographical market data.

Min: $22/hr / Max: $24/hr

Benefits – Full-time positions are eligible for our comprehensive and competitive benefits package including medical, dental, vision, and basic life insurance. Additional benefits include a 401k plan paid time off and an annual bonus. International SOS Government Medical Services complies with all federal, state, and local minimum wage laws.

International SOS Government Medical Services is an equal opportunity employer and does not discriminate against employees or job applicants on the basis of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with the applicable federal, state and local laws.

International SOS Government Medical Services is an equal opportunity employer and does not discriminate against employees or job applicants on the basis of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state and local laws.