Credentialing Coordinator
Company: US Tech Solutions, Inc.
Location: Cumberland
Posted on: May 28, 2023
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Job Description:
Title: * Credentialing Coordinator
Location: Cumberland, RI 02895
Duration: 12 months
Position Summary:
This is a floating position between Medical Affairs Department and
the Credentialing Department. The Credentialing Coordinator is
responsible for initial credentialing and re-credentialing nurse
practitioners, physician assistants and physicians in a compliant
and timely manner; monitor expired credentials and compliance
monitoring in accordance with Joint Commission accreditation, NCQA
and URAC credentialing standards as required. The Medical Affairs
Office Coordinator has primary responsibility for the non-clinical
aspects of physician operations administered. In this role you will
be a part of a collaborative cross-functional team charged with
ensuring that the evolving administrative physician operations
which support Health comply with internal and external regulations,
standards, and practices.
Duties:
- Timely and accurate processing of all providers including
NP's/PA's/MD's initial and Re-credentialing applications according
to the Provider Credentialing Program
- Monitor Expired licensure reporting , data base tasks and
maintain system updates and weekly reporting to leadership
- Process malpractice insurance verification requests according to
internal policies
- Monitor Provider and Clinic change/Termination reports and update
data base accordingly
- Support Payer Audits in accordance with, Joint Commission and
NCQA requirements
- Partner with assigned Medical Directors to ensure physician
recruiting and staffing is meeting the needs of the business
- Support physician recruiting, licensing, and credentialing
efforts
- Ensure physician contracts are kept current and accurately
reflect duties and compensation
- Support provider onboarding by ensuring Collaborative Practice
Agreements and/or prescriptive authority documents are fully
executed, filed, and maintained as applicable.
- Utilize the MDStaff database to record pertinent information
- Physician payroll and other financial, budgetary activities as
assigned.
- Participates in other departmental activities as assigned
Experience:
- 3+ years of experience working in a fast-paced, complex
administrative environment, preferably in healthcare
- Demonstrated understanding of initial credentialing and
re-credentialing practices for medical professionals including
primary source verification methods, compliance monitoring and
expirable management.
- Understanding of Joint Commission Accreditation, NCQA and URAC
credentialing standards.
- NAMSS Certified Professional Credentialing Specialist (CPCS)
certification
- Comfortable with communicating at all levels in the
organization.
Skills:
Pharmacy, insurance, healthcare, medical
Keywords: US Tech Solutions, Inc., Providence , Credentialing Coordinator, Other , Cumberland, Rhode Island
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