Job description
Job Summary:
The Credentialing Coordinator is responsible for data entry, collection, and primary sourceverification of healthcare practitioner licenses and certifications, including in-depth and detailed research of information. The primary methods of research include internet, phone, fax, e-mail, and letters. The individual in this role works to ensure Process Excellence through the identification and verification of timely and accurate credentialing of Healogics providers with the goal of creating Exceptional Patient Experiences and quality outcomes.
All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
Schedule: Monday through Friday, 8AM to 5PM, No Weekends/No Holidays!
Essential Functions/Responsibilities:
- Contact providers to initiate credentialing or re-credentialing
- Track license and certification expirations for all providers to ensure timely renewals
- Set up and maintain provider information in credentialing database
- Verify Education, Employment, Board Certifications, Licenses, DEA, and NPDB using primary source verifications
- Update expiring documents such state licenses, DEA licenses, and malpractice insurances
- Manage and organize the credentialing folders and files
- Data entry into the provider database
- Contact providers for follow-up calls
- Introduce initial hospital appointment or reappointment
- Perform other duties as required
Required Education, Experience and Credentials:
- Associate’s Degree plus a minimum of three (3) years’ experience and/or training
- Bachelor’s Degree, preferred; or
- Equivalent combination of education and relevant experience
- Must be familiar with the credentialing process; a hospital, or other healthcare organization; NCQA credentialing standards
Required Knowledge, Skills and Abilities:
- Familiarity with medical terminology
- Strong computer skills (typing and data entry including proficiency in MS Word, Excel, and web-based application, internet, and database programs)
- Organization, prioritization, and time management skills with the ability to meet overlapping deadlines
- Detail-oriented with ability to recognize vital information from verification documents
- Ability to work independently
- Ability to follow-up on calls, emails, faxes and obtain results in a timely manner
- Clear and concise phone and verbal communication skills
- Effective written communication skills
- Proof-reading skills sufficient for auditing documents
- Problem-solving, critical thinking, and deductive reasoning skills
Please contact Jennifer.Chard@healogics.com for further information
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