Credentialing Coord

Job Summary

The Credentialing Coordinator is responsible for all aspects of the privileging and credentialing process for the health care provider. This includes the accurate, timely and documented verification of the information provided by the applicant and maintenance of the highly confidential credentialing related files. This position is not remote work.

Primary Functions

• Assists with the on boarding process of Medical and Dental Providers and Pharmacists along with facility credentialing.
• Processes provider credentialing applications in accordance with accreditation standards, regulatory requirements, and policies and procedures.
• Examines, researches, enters data, files, and gathers all information necessary to process information received from providers to support the credentialing process.
• Maintains compliance with documentation standards for verification of employee credentialing requirements, including but not limited to licenses, certifications, registrations, permits, educational degrees, association memberships and any related electronic systems and software.
• Provides consistent, accurate, and timely credentialing support, enhancing the organization's ability to provide professional services.
• Responsible for the maintenance and accuracy of electronic employee credentialing files.
• Verify, research, and respond to telephone inquiries and written inquiries, from providers and other departments, pertaining to provider participation and credentialing status in a professional and courteous manner.
• Maintain all additions, terminations, and changes to all plans as appropriate.
• Monitors medical and business licenses for upcoming expiration dates and takes appropriate action to ensure all renewals are completed in a timely manner.
• Intranet maintenance of credentialing status.
• Other responsibilities as assigned
  
  

Education And Experience

• High school diploma or equivalent
• Minimum of two (2) years experience in Administrative/Office Assistant role.
  
  

Knowledge, Skills, And Abilities

• Reads, speaks, understands and writes proficiently in English.
• Works independently and is self-directed.
• Effective presentation skills.
• Relates and interacts with staff at all levels of the organization.
• Represents the organization in a professional and effective manner to the community.
• Works effectively in a team environment.
• Organizes, prioritizes, and coordinates multiple activities and tasks.
• Works with initiative, energy and effectiveness in a fast-paced environment.
• Problem-solves with creativity and ingenuity.
• Proficiency in the use of Microsoft Office applications; Word, Excel, Outlook and PowerPoint.
• Communicates effectively both orally and in writing.
• Experience with intra and internet functions.
• Operates standard office equipment
  
  

Additional Qualifications

• Bilingual a plus (English / Spanish)
  
  

RELATIONSHIP REPORTING

• Reports to the Credentialing Manager
  
  

Physical Requirements

• Ability to sit, stand, walk or view a computer screen for extended periods of time
• Ability to perform repetitive hand and wrist motions for extended periods of time