Description
CREDENTIALING COORDINATOR JOB SUMMARY
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.
CREDENTIALING COORDINATOR 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.
- Coordinates compliance for legal and regulatory documentation for the professionals of CCHC.
- Monitors accuracy of policies and procedures, 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.
- Coordinate with the payer to ensure that 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.
- Assist 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.
CREDENTIALING COORDINATOR 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
Requirements
CREDENTIALING COORDINATOR 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 supports 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.
- Performs other related duties as assigned.
CREDENTIALING COORDINATOR PAY RATE: $25-$27/hr
CREDENTIALING COORDINATOR BENEFITS:
- Medical, Dental and Vision – 100% paid by Employer
- Life Insurance and Accidental Dismemberment – 100% paid by Employer
- Paid Holidays
- Paid Time Off
- Wellness Day Off
- 401(k) and 401(k) matching
- Flexible Spending Account
- Fringe
- Supplemental Insurance
