Credentialing Coordinator - Full time - REMOTE - (VA,NC, SC, TN, WV, TX, MD )

About the role

The Credentialing Coordinator is responsible for all aspects of the initial credentialing, re-credentialing and privileging functions for all clinicians on medical and allied health staff at the VCU Health System Hospitals.

Responsibilities

• Interacting with clinicians to obtain applications and pertinent documents evaluating data for accuracy and completeness
• Monitoring receipt and follow up responses ensuring timely and efficient processing
• Notifying supervisor Director of any adverse, incomplete or questionable data
• Absorbing and assessing situations, considering alternatives, and choosing the appropriate course of action
• Maintaining strict confidentiality and professional discretion
• Ensuring compliance with hospital bylaws, and with local, state and federal requirements
• Providing assistance to the Director in development, plans, organization and control of the operation of the Medical Staff Office in order to meet the mission and goals of the hospital and the requirements of the Medical Staff Bylaws, JCAHO, NCQA Standards and other applicable federal, state and local regulatory and/or accrediting agencies
• Attending medical staff committee meetings as directed
• Interacting and providing support services to medical staff officers, departments and chairs as assigned

Requirements

• Licensure, Certification, Or Registration Requirements For Hire: Certified Provider Credentialing Specialist (CPCS) preferred
• Licensure, Certification, Or Registration Requirements For Continued Employment: Certified Provider Credentialing Specialist (CPCS) preferred
• Experience REQUIRED: Minimum of three (3) years previous credentialing and medical terminology experience in a hospital or managed care credentialing setting
• Previous experience using a personal computer and various applications, including Microsoft Office Access, Word, and Excel and credentialing software
• Experience PREFERRED: Five (5) years of previous experience in credentialing in a health care environment
• Previous experience with the application of JCAHO, URAC and NCQA guidelines
• Certified Professional in Medical Services Management (CPMSM)
• Education/training REQUIRED: Associates or Bachelors degree or experience in lieu
• Education/training PREFERRED: Associates or Bachelors Degree in Business, Healthcare or closely related field

Qualifications

• Independent Action(s) Required: Expresses ideas and exchanges information clearly and concisely. Demonstrates the ability to prioritize work assignments effectively and efficiently within the scope of the employee’s responsibility. Effective development of relationships with other members of the team (i.e. non-clinical personnel, etc.) Highly motivated individual with independent work habits. Organizational skills, proficiency in MS Office Access, Word, and Excel and credentialing software, and numerous hospital databases with extreme attention to detail are critical indicators for success in this role. Ability to multi-task in stressful and limited time constrained environment. Must possess knowledge of local, federal and state laws and regulations and JCAHO standards related to position’s chief objective and demonstrate aptitude for compliance with VCUHS policies, procedures, and customer service philosophy.

Skills

• Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking

Benefits

N/A

Pay

N/A

Schedule

N/A