Credentialing Coordinator – III
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Job Description
Credentialing Coordinator managing physician and provider credentialing, verification, and compliance for Sutter Health. Maintaining accurate licensure, certification, liability, and claims databases.
Responsibilities:
- Complete credentialing functions
- Ensure program integrity and compliance with standards, federal/state requirements, and health plan credentialing requirements
- Maintain relationships with health plan auditors
- Communicate and work with physician leaders on credentialing issues
- Work with other departments on areas related to credentialing issues
- Audit Credentialing Verification Organization released files to ensure primary source verification of required physician information
- Maintain current and accurate database 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)
- 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
- Ability to analyze data/reports and to make recommendations
Benefits:
- Comprehensive benefits package
- Eligible positions include a comprehensive benefits package
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