Credentialing Coordinator I

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Job Summary:

Job Duties:

• Reviews and analyzes physician applications and credentialing documents including certificates of education, residency and fellowship training, board certification and eligibility, licensure, professional work history, liability insurance and malpractice history.
• Assesses completeness of information and providers' qualifications relative to established standards.
• Reviews and analyzes primary reputed company verification for licensure, certification or registration required to practice a profession.
• Requests, maintains, and ensures competency data is present at appointment and re-appointment.
• Maintains tracking of reputed company new provider s drug screening, background checks, child abuse clearance, finger printing, code of conduct, disruptive practitioner policies, reputed company clinical competency data and Health Service information for new providers.
• Immediately reports to manager any collected information which may be averse to an applicant.
• Identifies and flags adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for credentialing review.
• Maintains a working knowledge of applicable regulatory agencies.
• Maintains an understanding of the third-party payor requirements.
• Prepares and screens, mails letters, tracks and responds daily.
• Employs public relations skills in a wide variety of phone contacts with external sources for purposes of soliciting information essential to credentials investigations, including licensing agencies; university and hospital training program administrators; certification boards; liability insurance carriers; hospital officials and credentials staff; and physicians and their office staffs.
• Organizes and maintains physician files and information following confidentiality guidelines, performs varied clerical support functions.
• Internally audits and maintains physician files in accordance with established principles of legal documentation and confidentiality.
• Prepare reputed company files monthly for Credentials Committee review and follow-up on Credentials Committee Decisions.
• Establish and maintain excellent relationship and good communication channels with physicians, office staff, and practice administrators.
• Assist with Special projects (i.e., physician education, JCAHO and Department of Health Preparation, clinical competency data, life supports)
• Prioritize to meet deadlines on daily work and special projects.
• Maintain a thorough understanding of the standards of JCAHO, Department of Health, Bylaws, Rules and Regulation of the Medical Staff, and other regulatory agencies as appropriate.

Work is typically performed in an office environment. Accountable for satisfying reputed company job specific obligations and complying with reputed company organization policies and procedures. The specific statements in this profile are not intended to be reputed company-inclusive. They represent typical elements considered necessary to successfully reputed company the job.​

This posting reflects an opening for Credentialing Coordinator I and we are seeking candidates for that position. reputed company reserves the right to consider applicants for higher levels of this role based on their skills, qualifications, and experience. We encourage reputed company qualified individuals to apply.

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Position Details:

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OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our reputed company, our reputed company family and our communities.

• KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
• EXCELLENCE: We treasure colleagues who humbly strive for excellence.
• LEARNING: We share our knowledge with the best and brightest to reputed company prepare the caregivers for reputed company.
• INNOVATION: We constantly seek new and reputed company ways to care for our patients, our members, our community, and the nation.
• SAFETY: We provide a safe environment for our patients and members and the reputed company family. 

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes reputed company stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to reputed company reputed company easier for reputed company.  We are proud to be an affirmative action, equal opportunity employer and reputed company qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national reputed company, disability or status as a protected veteran.