Credentialing Coordinator

Job Description

Benefits:

401(k)

401(k) matching

Dental insurance

Flexible schedule

Health insurance

Home office stipend

Opportunity for advancement

Paid time off

Training & development

Vision insurance

Growing fast paced practice in search of an energetic, knowledgeable, and dependable credentialing coordinator. Superior organizational skills a must, must be able to efficiently multi-task and keep up with face paced environment, and must able communicate effectively with providers, leadership, health plans, and peers.

The Credentialing Coordinator is responsible for assuring that the credentialing of practitioners is conducted in accordance with credentialing policies and procedures, entity bylaws/credentialing plan, regulatory agencies, and accrediting bodies. The Credentialing Coordinator performs quality control audits and coordinates the preparation of completed practitioner files, maintains accurate records regarding the processing status of each practitioner, and flags potentially adverse information. The Credentialing Coordinator is responsible for assuring all activities are conducted as scheduled and per departmental standards.

Processes initial credentialing and reappointment applications, reviews for completeness, verifies information through appropriate resources, and processes the applications in a timely manner and as defined in Credentialing Policies.

Review all returned application materials for appropriateness and completeness, insure that documentation of all training and experience for requested privileges is provided and maintain an on-going dialogue with the applicant and other interested parties to assure that applicants are credentialed by their start/reappointment date.

Follow up with leadership, practitioners and other respondents regarding incomplete/missing information on documents received.

Maintains paper/electronic credentials files, clinical privilege forms (as assigned) and practitioner databases to insure information contained is accurate and current. Effectively utilizes all software systems to perform essential job functions, adhering to established data entry conventions.

Perform electronic, written and telephonic queries to health plans. Assess content of responses to determine any follow up required.Flexible hybrid work schedule available, great opportunities for career advancement.

Flexible work from home options available.