ProvidenceRecruiter Since 2001
the smart solution for Providence jobs

Credentialing Coordinator

Company: US Tech Solutions, Inc.
Location: Cumberland
Posted on: May 28, 2023

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.

- 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

- 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.

Pharmacy, insurance, healthcare, medical

Keywords: US Tech Solutions, Inc., Providence , Credentialing Coordinator, Other , Cumberland, Rhode Island

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Log In or Create An Account

Get the latest Rhode Island jobs by following @recnetRI on Twitter!

Providence RSS job feeds