Credentialing Coordinator

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The Credentialing Coordinator will oversee all facility credentialing and payor enrollment for healthcare providers working in the anesthesia department of Methodist Le Bonheur, ensuring compliance with regulatory standards, organizational By-Laws and policies, procedures, and protocols. This role involves managing facility credentialing and payor enrollment processes, including: maintaining accurate and up-to-date provider credentialing and enrollment records, and facilitating communication between internal departments, vendors, and external agencies.

This role requires some onsite presence throughout the hospital network but can be performed as remote.

Responsibilities of the Credentialing Coordinator:

Credentialing Process Coordination:

·Oversee the credentialing process for anesthesia
healthcare providers, including physicians, CRNAs, and allied health
professionals.

·Develop, implement, maintain and enforce credentialing policies and procedures in
compliance with facility By-Laws, department policies, accreditation standards
and regulatory requirements.

·Coordinate with the individual clinicians, MLBH medical staff office, and other
departments to ensure timely completion of credentialing and recredentialing
applications.

·Coordinate with the individual clinicians, billing company, and other Somnia departments
to ensure timely completion of enrollment and reenrollment applications.

Provider Credentialing:

·Manage and coordinate the initial credentialing, privileging, and enrollment process
for new anesthesia providers, including verification of credentials, licensure,
DEA certificates, education, training, and professional references.

·Ensure all credential files are accurately maintained and updated according to
established protocols.

· Conduct quarterly audits of credentialing files to ensure accuracy, completeness, and compliance and identify areas of opportunity.

Communication and Collaboration:

·Serve as a liaison between clinicians and Somnia credentialing department, MLBH
credentialing Department, medical staff office, clinicians, local Somnia and
MLBH administration; as well as external agencies such as insurance providers
and regulatory bodies.

·Communicate credentialing requirements and updates to internal stakeholders and provide
guidance on credentialing-related matters.

· Maintain accurate and up-to-date provider credentialing data in the credentialing database or software system; or if said systems are not in place, Excel spreadsheets.

· Generate pipeline reports (e.g.; 30, 60, 90, 120+) and analyze data related to credentialing activities, provider status, and compliance metrics for management review.

Qualifications for the Credentialing Coordinator:

· Minimum of 3 years experience in healthcare credentialing.

· In-depth knowledge of credentialing standards and regulations, including The Joint Commission (TJC), National Committee for Quality Assurance (NCQA_ and Centers for Medicare & Medicare Services (CMS) requirements.

· Strong leadership, organizational and problem-solving skills, with the ability to interact effectively with diverse stakeholders.

Job Type: Full-time

Compensation: $55,000 annually

Work Location: Memphis, TN onsite at Methodist Le Bonheur with remote flexibility.

Benefits for the Credentialing Coordinator:

· Health | Dental | Vision | Life | Disability

· 401K | Flexible Spending Accounts

· Paid Time Off

About Somnia Anesthesia

Since 1996, Somnia (www.somniainc.com) has had singular focus on anesthesia--investing in clinician professional development—so patients can get the best are possible. We welcome and encourage applicants of all races, colors, genders, religions, sexual orientations, national origins and disabilities, as well those who have served.

Job Type: Full-time

Pay: $25.48 - $26.44 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to Relocate:

• Memphis, TN 38104: Relocate before starting work (Required)

Work Location: In person