Credentialing Coordinator

This is a fully remote position, open to applicants in Oregon.

📋 Description

• Oversee the credentialing, reappointment, privileging, and ongoing monitoring processes for medical staff and allied health professionals.

• Manage the processing of initial appointment and reappointment/privileging applications in accordance with established policies and procedures.

• Implement legal, state, OHSU, DNV, TJC, and NCQA guidelines to ensure adherence to regulatory requirements.

• Identify, investigate, and confirm discrepancies and adverse information from applications, primary source verifications, and various sources.

• Maintain regular communication with credentialing contacts to guarantee timely and accurate completion.

• Organize and secure confidential practitioner credential files that include peer review information.

• Conduct primary source verification, acquire clinical activity documentation, and execute OIG, Opt-Out, and NPDB searches.

• Monitor responses, follow up on missing information, and secure approvals for presentations to the Medical Executive Committee/Governing Board.

• Work in collaboration with physician leaders, the Credentialing Supervisor, and the Medical Affairs Director on criteria-based clinical privileging systems.

• Preserve confidential credentialing database information for appointments, reappointments, additional privileges, temporary privileges, and status changes.

• Document each step of the credentialing process and update database records from the receipt of applications through to completion.

• Coordinate meeting logistics, prepare documentation, and conduct follow-up at Hillsboro Medical Center.

• Perform additional duties as assigned.

⛳️ Requirements

• High School Diploma or GED is required, along with 3 years of medical staff credentialing experience in a healthcare or insurance provider environment; OR an associate's degree and 3 years of experience in data collection or data analysis using complex database software systems; OR a combination of education and experience.

• Proven experience with software databases for generating letters and correspondence, tracking activities, and producing reports.

• Knowledge of legal, state, TJC, and NCQA guidelines for medical staff regulatory compliance.

• Strong verbal and written communication skills that are clear, concise, and effective.

• Capability to organize tasks, set priorities, and establish goals and strategies.

• Ability to foster productive relationships with both internal and external stakeholders.

• Understanding of laws, regulatory agency requirements, and standards.

• Independent problem-solving and decision-making skills.

• Sensitivity in handling highly confidential information and communications.

• Proficiency in word processing, computer systems, data interpretation, and evaluating complex credentialing and privileging scenarios.

• Capacity to perform essential functions with or without accommodation.

• An associate or bachelor’s degree is preferred.

• Previous experience in hospital medical staff credentialing and privileging is highly desirable.

• Experience with CredentialStream or similar credentialing software is preferred.

• Background in supporting medical staff committees is preferred.

• CredentialStream database experience is preferred.

• Experience in hospital credentialing/recredentialing is preferred.

• Certification as a Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) is preferred.

🏝️ Benefits

• Regular full-time position.

• Monday–Friday schedule, 8:00am–4:30pm.

• Full-time remote position.

• Union-represented position (AFSCME).

• Opportunities for learning and advancement within a network of hospitals and clinics throughout Oregon and Southwest Washington.

• Reasonable accommodation available upon request.