Credentialing Coordinator
Posted 1ds ago
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Job Description
Credentialing Coordinator at Sutter Health ensuring compliance with standards and health plan requirements. Responsible for credentialing functions and maintaining physician information databases.
Responsibilities:
- Responsible for completion of credentialing functions
- Ensures program integrity and compliance with standards, federal/state requirements, and health plan credentialing requirements
- Maintains relationships with health plan auditors, communicates and works with physician leaders on credentialing issues
- Works with other departments in multiple areas that relate to credentialing issues
- Audits Credentialing Verification Organization's released files to ensure it obtains primary source verification of required physician information
- Maintains database of current and accurate information concerning licensure, board certification, professional liability coverage and claims for physicians, contracted providers and Allied Health Professionals
Requirements:
- HS Diploma or General Education Diploma (GED)
- 2 years recent relevant experience
- Knowledge of medical provider credentialing and accreditation principles, processes, procedures, and documentation
- Knowledge of computer spreadsheets and other related applications
- Ability to use independent judgment and to manage and impart confidential information
- PC skills (MS Word, MS Excel, and MS Access) and proficiency regarding data entry skills
- Organizational skills with ability to prioritize, problem solve and meet deadlines
- Ability to analyze, interpret, and draw inferences from research findings, and prepare reports
- Able to use independent judgment and to manage and impart confidential information
- Ability to analyze data/reports and to make recommendations
Benefits:
- Yes
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