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.

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