Credentialing Coordinator
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Job Description
Remote credentialing coordinator completing physician credentialing and recredentialing applications for Trinity Health. Maintaining provider data, verifying records, and supporting healthcare compliance processes.
Responsibilities:
- Ensure timely completion of initial and recredentialing applications
- Assist applicants in submitting documentation required to process applications
- Perform credentialing tasks under the direction of CVO management for Trinity Health RHMs
- Follow credentialing policies and procedures
- Maintain an accurate physician database
- Collect data and participate in credentialing process changes
- Identify and schedule reappointment candidates
- Audit files and provide feedback on credentialing files
- Assist with training and orientation of new team members
- Perform daily data entry and data conversion for new RHMs
- Communicate with applicants and RHMs to complete credentialing requirements within specified timeframes
- Contact primary sources to gather verifications by telephone, fax, mail, and Internet
- Prepare verification documentation and reference summaries
- Assist with reappointment applications and follow-up
- Meet processing time thresholds with minimal error
- Assist with drafting RHM privilege forms in the credentialing database
- Maintain confidentiality of patient, physician, employee, visitor, and external-entity information
- Track errors and complaints to support process improvement
- Maintain knowledge of applicable laws, regulations, standards, compliance programs, and policies
- Perform other duties assigned by the Director
Requirements:
- Two years of post-high school education, training, or experience
- One year of work experience in a health care environment
- General knowledge of the health care industry, including hospital settings, physician practices, and managed care organizations
- Knowledge and understanding of NCQA and TJC standards, NPDB guidelines, hospital policies and procedures, and general licensing regulations
- Knowledge and experience with database organization and management
- Experience with report generating languages, PCs, and Windows-based word processing software
- Strong communication skills
- Strong statistical, analytical, and problem-solving skills
- Ability to provide quality service
- Strong organizational skills and attention to detail and thoroughness
- Ability to work autonomously and within a team environment
- Ability to comply with Trinity Health policies and procedures
- Current CPCS and/or CPMSM eligibility preferred but not required
Benefits:
- Professional development programs
- Participation in professional organizations
- Equal Opportunity Employer
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