Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process for VEP physicians and advanced practice clinicians (APCs). Facilitates all aspects of credentialing, including initial appointment, reappointment, expirables process. Responsible for the accuracy and integrity of the credentialing database system and related applications. Works under the supervision of the Director of Provider Services & Staffing but takes functional guidance from the Sr. Credentialing Coordinators.
Verifying the credentials of all VEP providers
Ensuring compliance with Federal, State, The Joint Commission, and VEP contracted hospitals’ requirements.
Facilitate and maintain appropriate provider billing documentation for both self-bill hospitals and contracted billing companies.
Keep recruitment team and medical directors informed of new provider’s privileging status.
Conduct and complete audits to ensure providers maintain current licenses, certifications and malpractice insurance certificates.
Update and maintain credentialing database of all provider data and hospital listings.
Provide support to and work in collaboration with VEP contracted hospitals and billing companies to maintain proper documentation.
Maintain contracted hospital’s criteria listing.
Regularly communicate and provide ongoing support to providers.
Direct experience with billing and Medicare provider enrollment
Experience with the various agencies used to verify provider qualifications
Advanced experience with MS Office suite, filing, organizing, and standard office equipment.
Demonstrated commitment to customer service & detail oriented.
Ability to multi-task competing priorities.
Displays a positive attitude,
Experience with MS Office Suite, applicant tracking systems, credentialing software and Doc-U-Sign.
Education and Work Experience Requirements:
High school diploma or GED; at least 6 years of experience with four years directly related to hospital medical staff or managed care credentialing. A higher degree from an accredited institution may be substituted for experience on a year-for-year basis, up to two years. NAMSS certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) or actively seeking certification and ability to become certified within one year.
At least 2-4 years of credentialing experience at a hospital or medical group
Certified Provider Credentialing Specialist certification