Lead Credentialing Coordinator

Job Description

Credentials and supports the administrative functions of the Credentialing Verification Office (CVO).

• Coordinates and provides administrative support in processing, verifying, and maintaining credentialing information for new applicants and re-applicants.
• Performs and tracks primary source and other required verifications for all applicants according to established policies and procedures.
• Responds to customer inquiries and resolves problems within established policies and procedures.
• Prepares and provides client advisory reports including status reports, expired items reports, and completed file reports to meet contractual time frames.
• Uses critical thinking skills to flag incongruent issues or information during credentialing.
• Ensures credentialing database is maintained. Manages integrity of database and appropriateness of hard data.
• Copies information received and provides it to contracted entities.
• Produces tracking reports to detect and resolve work in process issues.
• Populates, updates, and verifies correctness and completeness of database information on an ongoing basis.
• Provides departmental administrative support to Director in carrying out CVO activities.
• Helps coordinate completion of related projects, including special project requests as assigned.

Knowledge, Skills, and Abilities

• Demonstrated experience in effectively providing medical staff services and support.
• Ability to communicate (verbal/written) effectively at different levels of the organization.
• Demonstrated interpersonal skills and ability to support and work in collaboration with multiple sites as needed.
• Professional demeanor, business acumen, political astuteness, adaptability and diplomacy combined with the ability to establish and maintain collaborative relationships across the organization.
• Demonstrated client management skills including customer service and physician relations.
• Team oriented with high degree of initiative; a self-starter with demonstrated data entry and administrative skills.
• Highly detail-orientated and organized with analytical and critical thinking skills.
• Results driven with the ability to effectively multi-task, and manage conflicting priorities is essential.
• Ability to function in demanding, stressful and fast paced confidential environment.
• Computer skills and proficiency in MSOffice (Word, Excel, Access, PowerPoint, Outlook), document imaging (i.e. fax, scanner, Image Now).
• Prior experience in credentialing, privileging and practitioner database management or related experience.
• Able to communicate effectively in additional languages (i.e. Spanish) [Preferred]

Education

• Associate [Preferred]
• High School Grad or Equiv [Required]
• Field Of Study in business or health related field. [Required]

Work Experience

• 10+ experience in medical staff services, managed care credentialing or in a centralized verification office. [Required]

Additional Information

N/A

Licenses And Certifications

• Certified Provider Credentialing Specialist (CPCS) [Preferred]

Physical Requirements

View physical requirements

Pay Range

$24.21 - $45.02