Credentialing Specialist

Credentialing Coordinator

Our client, a premier leading academic medical center located in the metropolitan New York area, is seeking to hire a Credentialing Coordinator.

Job Responsibilities:

· Oversee all aspects of the timely credentialing and re-credentialing of staff

· Follow-up with applicants on missing documentation and preparing files for applicable department and hospital committee approvals

· Act as liaison between applicants and hospital departments

· Prepare appointment and reappointment applications for Department Chairperson, CredentialsCommittee, Medical Executive Committee and Board of Directors committee reviews

· Oversees database management of demographic information on practitioners and tracking/updating of expired and incomplete information including content on current status of license registrations, board certifications, and other types of certifications· Follow-up with applicable practitioners to update documents

· Maintain database on practitioners on all expirables and other mandated primary source verifications

· Act as liaison to hospital departments to ensure optimum third-party plan participation of newly credentialed providers

· Assist in all aspects of operations to ensure department compliance with regulatory standards including, the Joint Commission, NCQA, DOH, CMS

· Prepare provider files in response to requests from government and regulatory agencies

· Prepare practitioner files for government and regulatory agency credentialing audits

· Participate in audits

· Participate in performance improvement projects designed to improve the efficiency and
effectiveness of department operations.

· Oversight and monitoring of FPPE/OPPE process for the medical staff and allied health professionals during the provisional appointment period and ongoing data collection for provider competency evaluations in compliance with regulatory requirements for reappointment

· Act as interface between credentialing/privileging and peer review processes
Assist department director in policy and procedure development relating to credentialing and privileging

Job Requirements:

· Associate degree

· NAMSS certification as a CPCS or CPMS is a plus

· Proficient in the utilization of credentialing and privileging software

· 3+ years work experience, preferably in credentialing or medical staff office operations or in other health care setting

· Excellent interpersonal skills and writing skills

· Ability to manage several tasks simultaneously

· Computer literacy, working knowledge of word processing and spreadsheet applications

· High degree of responsibility for confidential matters

· Ability to work independently

· Knowledge of Joint Commission and State requirements and related record keeping preferred

· Ability to function in a demanding environment, navigating multiple projects simultaneously, and
effectively supporting a busy medical staff office

Job Perks:

· Competitive salary, great benefits, and other attractive incentives

· Generous PTO

· All major insurances (health, life, disability)

· Work-life balance is valued

· A team environment that believes in employee development, professional growth, and company longevity

· Culture is one of mutual respect, teamwork, and equality

· The organization embraces and values an inclusive work environment