What are the responsibilities and job description for the Credentialing Coordinator position at Managed Staffing?
Job Description
Job Description
The Credentialing Coordinator is responsible for initial credentialing and re-credentialing nurse practitioners, physician assistants and physicians in a compliant and timely manner; monitor expired credentials and compliance monitoring in accordance with Joint Commission accreditation, NCQA and URAC credentialing standards as required.
Responsible for the timely and accurate processing of all providers including NP's / PA's / MD's initial and Re-credentialing applications according to the Minute Clinic Provider Credentialing Program
Monitor Expired licensure reporting , data base tasks and maintain system updates and weekly reporting to leadership
Manage Epic access for any providers that have out of compliance licensure and / or board certification.
Conduct sanctions and compliance monitoring and alert Credentialing Manager and Revenue Director of any undisclosed negative findings
Process malpractice insurance verification requests according to internal policies
Maintain the provider and physician SharePoint sites and Communicate provider status's with leadership and other internal teams to meet timelines
Submit system access requests upon credentialing approvals / clinic eligibility
Support the payer enrollment team as needed to resolve any payer claim issues
Monitor Provider and Clinic change / Termination reports and update data base accordingly
Process Name changes according to Minute Clinic policies and procedures
Daily maintenance of provider credentialing grids with notification to appropriate teams
Review and distribute all incoming mail as needed
Support Payer Audits in accordance with Minute Clinic, Joint Commission and NCQA requirements
Maintain provider files with the most current information / documentation
Notify system analyst and leadership of any system and state agencies interruptions / updates / password changes
Make recommendations for process improvement and system efficiencies
Attend and engage in all team meetings
Model a positive attitude in interactions with team members
Required Qualifications :
Demonstrated understanding of initial credentialing and re-credentialing practices for medical professionals including primary source verification methods, compliance monitoring and expireables management.
Proficient in quantitative analysis
Understanding of Joint Commission Accreditation, NCQA and URAC credentialing standards.
Ability to function independently and utilize critical thinking skills to accomplish goals and objectives
Effective communication skills; verbal and written
Strong interpersonal skills including the ability to work well with internal and external stakeholders
Strong organizational skills and the ability to multitask
Competent user of Microsoft Office, Outlook, Word, and Excel
A minimum of 3 years experience in the healthcare industry with experience in credentialing
Preferred Qualifications :
NAMSS Certified Professional Credentialing Specialist (CPCS) certification
Education - Verifiable High School Diploma is required.
Associates or Bachelor in business preferred.
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