HEALTHCARE CREDENTIALING COORDINATOR

Healthcare Credentialing Coordinator

The Credentialing Coordinator is responsible for the day-to-day processes for both FTCA/HRSA and payer Credentialing and Privileging programs of Comprehensive Community Health Centers. Ensures timely and accurate Credentialing and Privileging of all CCHC physicians and non-physician licensed professionals. The Credentialing Coordinator is responsible for maintaining the credentialing database platform.

Essential Duties and Responsibilities

• Coordinates and administers the Credentialing and Privileging process for all CCHC providers and non-physician licensed professionals.
• Maintain the Credentialing database platform.
• Covers compliance for legal and regulatory documentation for the professionals of CCHC.
• Makes sure policies and procedures are accurate, ensuring compliance with accrediting organization requirements.
• Create CAQH profiles for providers.
• Responsible for ensuring that all providers are contracted with different payers, including HMO's, Medi-Cal and Medicare.
• Collaborate with the payer to make sure all Credentialing requirements are met.
• Submit Credentialing forms and applications to IPA’s, Medical Groups and Plans as needed.
• Follow-up on submitted applications with IPA’s, Medical Groups and Plans.
• Functions as a credentials and privileging contact for all internal and external inquiries.
• Aid in developing innovative tools, features, and work flows to improve the Credentialing and Privileging processes.
• Works closely with HR to obtain all necessary documents for Credentialing and Privileging.
• Performs miscellaneous job-related duties as assigned.

Education and Experience

• Bachelor’s in a health-related field preferred.
• Credentialing knowledge and familiarity with industry standards required.
• Knowledge of Community Health Centers (CHC) and HRSA clinical staffing requirements preferred.

Knowledge, Skills and Abilities

• Ability to find solutions when barriers are identified.
• Strong documentation skills.
• Ability to multi-task and prioritize when needed.
• Ability to independently seek out resources and work collaboratively.
• Ability to read, understand and follow oral and written instructions.
• Experience and work ethics that support working within a high functioning, team-oriented environment.
• Demonstrates a willingness and ability to work under supervision.
• Ability to develop and maintain good working relationships with staff.
• Ability to use computer and learn new software programs.
• Excellent interpersonal skills reflecting clarity and diplomacy and the ability to communicate accurately and effectively with all levels of staff and management.
• Demonstrates ability to work in a regulatory climate that includes oversight of state and federal entities, payer contracts etc.
• Possesses ability to communicate effectively, both verbally and in writing.
• Possesses genuine respect for others and acceptance of their individual social and cultural traits.
• Proficient knowledge of Microsoft Outlook.
• Able to travel and attend professional meetings, conferences, trainings and clinic sites.
• Demonstrate flexibility, enthusiasm, and willingness to cooperate while working with others in multi-disciplinary teams.

Pay Rate

$25-$27/hr

Benefits & Perks

• 100% employer-paid Medical, Dental & Vision coverage
• 100% employer-paid Life & Accidental Death & Dismemberment (AD&D) Insurance
• 401(k) with employer matching
• Paid Time Off Accrual, 10 Paid Holidays, and a Wellness Day Off
• Flexible Spending Account (FSA)
• Fringe Marketplace Stipend
• Optional Supplemental Insurance
• Participation in CCHC's company-wide Profit Sharing Program (eligible employees)
• Professional development and opportunities for internal growth and advancement