Credentialing Coordinator

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

📋 Description

• Ensure the prompt completion of initial and recredentialing applications by assisting applicants with the necessary documentation.

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

• Adhere to credentialing policies and procedures while maintaining an accurate database of physicians.

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

• Aid in the identification and scheduling of candidates for reappointment.

• Conduct file audits and offer feedback on credentialing files.

• Support the training and orientation of new team members.

• Carry out daily data entry and facilitate the integration or conversion of new RHM data.

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

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

• Prepare verification documentation and summaries of validated references.

• Assist with reappointment applications, which includes gathering information, verification, and follow-up.

• Achieve processing time benchmarks with minimal errors.

• Help draft RHM privilege forms within the PCCB credentialing database module.

• Uphold the confidentiality of patient, physician, employee, visitor, and hospital information.

• Monitor errors and complaints to facilitate process improvement.

• Execute other duties as assigned by the Director.

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

• Adhere to safety practices and report any hazards.

⛳️ Requirements

• A minimum of two years of post-high school education, training, or experience is required.

• At least one year of work experience in a healthcare setting.

• Basic 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.

• Knowledge and experience with database organization, management, report generation languages, PCs, and Windows-based word processing software.

• Excellent communication skills.

• Strong statistical, analytical, and problem-solving capabilities.

• Outstanding organizational skills and a keen attention to detail.

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

• Compliance with Trinity Health policies and procedures is essential.

• Capability to prioritize tasks, adapt to frequently changing priorities, and manage multiple projects simultaneously.

• Ability to perform well under pressure while maintaining flexibility and a positive demeanor.

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

🏝️ Benefits

• Commitment to being an Equal Opportunity Employer.

• Opportunities for professional development and participation in professional organizations.