Credentialing Coordinator

Company : Universal Urgent Care And Occupational Medicine, I

Job Type : Full Time

Bakersfield, United States

Job Description - Credentialing Coordinator

Initiate, coordinate, monitor and maintain the credentialing and re-credentialing of all practitioners and allied health staff employed and/or contracted.
Will also assist to perform duties regarding various managed-care activities
Completion of health care professionals credentialing and re-credentialing applications including the privileging and re-privileging for all Practitioners and allied health staff employed/or contracted with all sites.
In addition, responsible for the completion of the credentialing and re-credentialing of Other Licensed and Certified Practitioners
Initiates and conducts primary source verification of practitioner’s background, education/training and malpractice history through the use of online systems, written correspondence, telephone inquiries and other acceptable credentialing methods
Identifies and evaluates potential red flags and works in collaboration with the credentialing manager to determine next steps
Performs ongoing monthly and quarterly compliance reporting
Analysis of report data and state board sanction information in compliance with regulatory on-going monitoring requirements
Is responsible for preparation of materials and files for presentation and review by credentialing committee
Perform data management and reporting from credentials database
Collaborates with inter-departmental peers, including Quality Management and Operations to identify and implement best practices and to ensure an integral, timely, and consistent product
Works with Human Resources/Operations department/Recruitment to ensure timely credentialing of new health care professionals

Requirements

Any combination equivalent to: An associate’s degree AND one year of credentialing experience in a managed care setting or experience in the medical field with a thorough understanding of credentialing and privileging
Background of strong administrative skills will also be considered
Proven ability to function independently with minimal direct supervision required
Strong organizational and communication skills required
Excellent oral and written communication, interpersonal and computer skills required
Proficient in Microsoft Office Suite (Outlook, Word, Excel)
Comfortable extracting and formatting data for ad hoc report requests
Attention to detail a must
Confidentiality required

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Credentialing Coordinator

Job Description - Credentialing Coordinator

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