Credentialing Coordinator

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

📋 Description

• Ensure the prompt completion of initial and recredentialing applications.

• Assist applicants in providing documentation necessary for the processing of applications.

• Execute credentialing tasks as directed by the CVO management for Trinity Health RHMs.

• Adhere to established credentialing policies and procedures.

• Maintain a precise database of physicians.

• Gather data and engage in modifications to the credentialing process.

• Identify and arrange schedules for reappointment candidates.

• Conduct audits of files and offer feedback on credentialing documentation.

• Support the training and orientation of new team members.

• Handle daily data entry and data conversion for new RHMs.

• Communicate with applicants and RHMs to fulfill credentialing requirements within defined timeframes.

• Reach out to primary sources to obtain verifications via telephone, fax, mail, and the Internet.

• Prepare verification documentation and summary references.

• Aid in reappointment applications and their follow-up.

• Achieve processing time targets with minimal errors.

• Assist in drafting RHM privilege forms within the credentialing database.

• Uphold the confidentiality of patient, physician, employee, visitor, and external-entity information.

• Track errors and complaints to facilitate process enhancements.

• Stay informed of relevant laws, regulations, standards, compliance programs, and policies.

• Perform additional tasks as assigned by the Director.

⛳️ Requirements

• Two years of education, training, or experience beyond high school.

• One year of professional experience in a healthcare setting.

• General understanding of the healthcare industry, including hospital environments, physician practices, and managed care organizations.

• Familiarity with NCQA and TJC standards, NPDB guidelines, hospital policies, and general licensing regulations.

• Expertise in database organization and management.

• Experience with report generation languages, personal computers, and Windows-based word processing software.

• Strong communication abilities.

• Excellent statistical, analytical, and problem-solving skills.

• Capability to deliver quality service.

• Strong organizational skills with a keen attention to detail and thoroughness.

• Ability to work independently as well as collaboratively within a team.

• Compliance with Trinity Health policies and procedures is essential.

• Current eligibility for CPCS and/or CPMSM is preferred but not mandatory.

🏝️ Benefits

• Opportunities for professional development.

• Involvement in professional organizations.

• Commitment to being an Equal Opportunity Employer.