What are the responsibilities and job description for the Credentialing Coordinator (289) position at Kings View Corporation?
Job Description
Job Description
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Kings View is a nonprofit leader in providing behavioral health services to the underserved community, is currently seeking a driven Credentialing Coordinator to join our mission to provide compassionate services to those with limited resources. Our ideal candidate will have a passion to promote social justice and societal awareness, respect for human dignity, and lead with integrity while listening and responding to the community in need.
Credentialing Coordinator (289)
Fresno, CA
Under the direction of the Director of Quality and Performance Improvement, the Credentialing Coordinator is responsible for coordinating, monitoring, and performing the credentials verification process for initial appointments and reappointments of physicians and allied health professionals. Incumbent will develop skills in all aspects of initial comprehensive credentialing and privileging to include reappointment process, requests in accordance with NCQA, DMHC and accreditation standards, state and federal regulatory requirements, bylaws, rules and regulations, policies, and procedures. The Credentialing Specialist serves as a liaison to delegated entities and vendors to ensure current and adequate credentialing processes are in place.
How will I contribute
- Develop and perform queries for data reporting purposes to include directories, hoc reports, and network management reports.
- Responsible for the maintenance of the provider database and providing provider-related reports to internal and external entities.
- Verify competence, medical and / or professional education, residency, internships, fellowships, additional formal training, relevant board certifications, health care affiliations, work history, military experiences, professional references, licensure and certifications, DEA certificates, malpractice coverage and privileges the applicant is requesting.
- Identify discrepancies in information and conduct follow-ups.
- Perform queries of the National Practitioner Data Bank as appropriate.
- Manage expireables as appropriate.
- Assist in research and defining criteria for new technology and privileges to present to department Committees for appropriate review and approval.
- Assist in annual review and updating rules and regulations, policies, and procedures.
- Process and maintain changes to staff status, ensure the currency and accuracy of all information.
- Ensure support, maintenance, and updating of the credentialing database system to include credentialing and other database systems as appropriate.
- Provide quality and ethical customer service to all practitioners, medical group liaisons, and other healthcare entities / partners.
- Facilitate meetings with program leadership on needs of program for credentialing, as needed.
- Facilitate training for Staff or Leadership on credentialing, as needed.
- Send and collect credentialing applications and reapplications.
- Maintain credentialing reports with contracted Health Plans / entities.
- Complete health plan provider profiles.
- Manage provider credential hard and electronic files.
- Ensure compliance with applicable laws, regulations, procedures, and policies.
- Performs other duties as assigned.
What I bring
The Benefits
Who We Are
Since 1951, Kings View leads the community in providing behavioral health services to the underserved population. We have a strong tradition of commitment, and we focus on serving rural communities where health resources are often limited. Our people treat the community with care and compassion. We stand by our cornerstone and philosophy of valuing each person’s worth, dignity and wholeness in body, mind, and spirit. Our principal core values echo throughout the organization and into our patient-focused programs. At Kings View we are dedicated to continuing our demonstration in the unparalleled commitment to wellness and recovery within each community we serve. Join us and apply today.
Salary : $1,000
