Position
Provider Credentialing Coordinator
Our client is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties.
Description
Credentialing Coordinator I is responsible for coordinating all provider credentialing activities for the Central Verification Office and acts as a liaison between the hospital medical staff departments, medical group and IPA credentialing departments, as well as the providers and their office staff. The position is responsible for the timely and accurate processing of all applications and related documents required to meet regulatory and plan requirements for credentialing.
Essential Functions And Responsibilities Of The Job
- Monitor and maintain timeliness while processing initial credentialing and re-credentialing files for physicians, mid-level practitioners, and other ancillary providers
- Responsible for tracking practitioner applications, verifications and other pertinent information regarding credentialing files for correctness, completeness in compliance with regulations and standards.
- Communicate with practitioners, practitioner's office staff, internal departments and outside institutions regarding credentialing status, verifications and activities.
- Update and maintain accurate credentialing database for both practitioner data and institution tables.
- Prioritize work activities and track progress on all files.
- Maintain a strict degree of confidentiality in all areas relating to provider credentials and status.
- "Other duties as assigned”
- LANGUAGE SKILLS: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customer or employees of the organization.
- MATHEMATICAL SKILLS: Ability to add, subtract, multiply and divide in all units of measure using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent to draw and interpret bar graphs.
- REASONING ABILITY: Ability to apply commonsense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
- OTHER SKILLS and ABILITIES: Proficient on Microsoft Word, Excel, Outlook and PowerPoint. Strong oral and written communication and research/problem solving skills. Attention to detail and accuracy. Ability to meet deadlines. Excellent interpersonal skills with a focus on internal/external customer satisfaction and teamwork. Proven dedication to quality, teamwork, customer service and professionalism.
- Prioritize and multitask
Requirements
Minimum Requirements
Qualifications/Work Experience:
- Minimum of 2 years related experience with Joint Commission/hospital medical staff credentialing and managed care NCQA credentialing along with the understanding of the associated regulatory requirements.
- Must have remote work experience
Education/Licensure/Certification:
- Associates degree (A.A.) in Medical Staff Management (MSSM) or equivalent from two year college or technical school preferred
- Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) preferred.
Additional Information
Full-Time, Remote
Prior Remote Work Experience Required
INDH