Credentialing Coordinator II

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

📋 Description

• Plan, coordinate, and supervise the procedures and processes of the Provider Credentialing Program to ensure compliance with regulatory standards.

• Conduct thorough background investigations on physicians and other providers, encompassing licensure, education, clinical training, board certification, disciplinary actions, malpractice history, and peer assessments.

• Review and evaluate physician applications and credentialing documentation.

• Assess the completeness of information and qualifications of providers in relation to established criteria.

• Analyze primary-source verifications for licensure, certification, or registration.

• Request, maintain, and verify competency data during both initial appointments and reappointments.

• Monitor drug screenings, background checks, child abuse clearances, fingerprinting, codes of conduct, policies, clinical competency data, and Health Service information.

• Report any adverse information regarding applicants to the manager and conduct follow-up investigations as necessary.

• Prepare, review, mail, track, and respond to correspondence.

• Reach out to external sources to gather information for credentialing investigations.

• Organize, maintain, audit, and manage physician files confidentially.

• Prepare documentation for the Credentials Committee review and follow up on the committee's decisions.

• Maintain effective communication with physicians, office staff, and practice administrators.

• Assist with special projects, including physician education, JCAHO and Department of Health preparations, clinical competency data, and life support training.

• Stay informed about JCAHO, Department of Health, Medical Staff bylaws, rules, regulations, and other relevant standards.

• Manage provider databases and extract data for reports, surveys, and provider directories.

• Adapt software to enhance credentialing operations and promote continuous quality improvement.

⛳️ Requirements

• High school diploma or equivalent (GED) is mandatory.

• A minimum of 4 years of relevant work experience is required.

• Strong communication skills.

• Proficiency in computer applications.

• Experience in credentialing processes.

• Professional presentation skills.

• Ability to work independently and efficiently.

• Familiarity with applicable regulatory agencies and credentialing standards.

• In-depth knowledge of JCAHO, Department of Health, Medical Staff bylaws, rules, and regulations.

• This position does not qualify for a J-1 waiver.

🏝️ Benefits

• Healthcare benefits available for both full-time and part-time positions from day one.

• Vision insurance coverage.

• Dental insurance coverage.

• Benefits for domestic partners.

• A collaborative, cooperative, and collegial work environment.

• An affirmative action and equal opportunity employer.