Credentialing Coordinator

CREDENTIALING COORDINATOR POSITION DESCRIPTION

Job Title: Credentialing Coordinator Supervised by: Credentialing Director

Job Summary: Responsible for performing various administrative, secretarial and clerical duties of the Credentialing Department. Understands and follows the organization’s policies, procedures and standards. Is an independent worker, meeting the day-to-day needs of the Credentialing Director. Participates in the department’s performance improvement activities.

DUTIES AND RESPONSIBILITIES:

Demonstrates Competency in the Following Areas:

  • Processes credentialing and recredentialing applications of health care providers
  • Assists the Credentialing Director with verification of information contained on applications.
  • Assists with the coordination of the biannual reappointment process of QPI clients.
  • Prepares meeting agendas, schedules meetings, reports, memos, correspondence, meeting minutes, special projects, etc., for the Credentialing Director.
  • Problem solves, able to recognize potential problems related to the credentialing application and notify team leader.
  • Answers the telephone in a professional manner; screens call, takes messages, directs calls appropriately.
  • Maintains confidentiality of all information.
  • Maintains an organized, efficient filing system.
  • Excellent customer service; well mannered.
  • Interacts professionally with all visitors, personnel within the department and in other departments.
  • Demonstrates the ability to be flexible and organized during stressful situations.
  • Manages and operates equipment safely and correctly.
  • Familiar with JCAHO and CAQH standards.
  • Accepts other duties as assigned.

Professional Requirements:

  • Adheres to dress code, appearance is neat and clean.
  • Completes annual education requirements.
  • Maintains regulatory requirements.
  • Maintains patient confidentiality at all times.
  • Reports to work on time and as scheduled, completes work within designated time.
  • Completes in-services and returns in a timely fashion.

Professional Requirements:

  • Attends annual review and department in-services, as scheduled.
  • Represents the organization in a positive and professional manner.
  • Actively participates in performance improvement and continuous quality improvement (CQI) activities.
  • Complies with all organizational policies regarding ethical business practices.
  • Communicates the mission, ethics and goals of the facility, as well as the focus statement of the department.

Language Skills:

  • Able to communicate effectively in English, both verbally and in writing.
  • Excellent communication skills.
  • Additional languages preferred.

Skills:

• Basic computer knowledge.
• Demonstrates leadership abilities.
Physical Demands:
• For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.
Regulatory Requirements:
• High school graduate or equivalent required.
• Secretarial training preferred.
• A minimum of three years credentialing experience in a medical setting required.

Language Skills:

• Ability to communicate in English, both verbally and in writing.
• Excellent interpersonal skills.
• Additional languages preferred.

Skills:

• Excellent computer, word processing, and data entry skills.

• Ability to take shorthand.
• Ability to operate office equipment.

Physical Demands:
• For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.