Credentialing Coordinator

Alteon Health - Germantown, MD

30+ days ago

Job Summary:

Responsible for all areas of the clinical staff credentialing process which includes initial appointments, reappointments, and maintenance of licensure for all entities in which they practice.

Duties and Responsibilities:

  • Mails hospital medical staff application packets to clinicians as requested by Recruitment
  • Process New Hospital and Licensure applications
  • Process Delegation Agreements for all Maryland applicants
  • Process Employment Protocols for all Virginia applicants
  • Process Medical Mutual Liability Insurance Applications and submit to professional liability insurance carrier
  • Submit all required documentation to Medical Staff Offices at the various hospitals
  • Submit copies of application and documentation to Billing for processing
  • Obtain weekly updates from hospital Medical Staff offices regarding outstanding items
  • Updates and distributes credentials report weekly
  • Lead weekly Credentials meeting outlining all files and relaying information to Scheduling, Recruitment, and Human Resources
  • Make follow up calls to various entities for outstanding application items
  • Keep applicants updated on their files’ progress and solicit their help if needed
  • Run reports on Licensure expirations through Horizon for State, DEA, and CDS licenses
  • Process license renewals and maintain current files of all licensure in Personnel files
  • Send copies of renewals to Medical Staff offices
  • Provide current licensure to Billing department
  • Process all Hospital Reappointment applications
  • Submit Reappointments, fees, and all required documentation to Medical Staff Offices
  • File copies of Reappointments in binders
  • File Reappointment letters from hospital
  • Maintain credentialing software and input all new employees into the database
  • Update all licensure information in credentialing software
  • Maintain Malpractice insurance binders with current certificates for each facility and forward to the appropriate hospitals
  • Coordinates daily operation of team and troubleshoots when necessary; Provides feedback and updates to Manager/Director of department
  • Assists Manager/Director with recognizing and providing coaching, mentoring, counseling, and discipline as appropriate; provides feedback concerning team member training needs; provides employees with support and motivation
  • Monitors and documents performance throughout performance periods
  • Provides manager with feedback regarding hiring and termination decisions
  • Possesses an enthusiastic and positive demeanor; promotes the Practice and motivates the staff
  • Ensures that all performance reviews are completed, conducted and turned in on time
  • Organizes, distributes and maintains the employee schedule
  • Works with manager to increase retention and minimize avoidable turnover
  • Responsible for time card processing/maintenance and attendance tracking
  • Provides thorough and accurate information to all customers
  • Responsive to customer questions; knows where and how to obtain information/answers
  • Communicates effectively and appropriately
  • Addresses workflow issues in a timely, professional manner
  • Follows all EMA and team policies and procedures
  • Demonstrates a level of professionalism and composure that is distinguishable for position level
  • Adheres to compliance policies, procedures, and protocols. Maintains a strict level of confidentiality and professionalism regarding patient, EMA and employee information
  • Willingly assists team with daily duties and other responsibilities as necessary; develops positive and collegial working relationships; coordinates and cooperates with others as appropriate
  • Maintains a “team” mentality within Practice and as a member of the leadership team
  • Identifies areas of improvement needed to promote the team
  • Understands and communicates policy, procedures, updates and revisions to staff
  • Takes an active role at staff and other meetings to promote and improve processes
  • Manages time effectively and efficiently
  • Uses resources appropriately when facing unfamiliar situations or tasks
  • Demonstrates a high-level of integrity and a proactive approach to customer service
  • Participates in the development, implementation and administration of projects as a member of the leadership team
  • Other duties as assigned

Requirements (Knowledge, Skills & Abilities):

  • Ability to speak, write, and read English fluently; ability to communicate clearly and effectively both orally and in writing
  • Ability to type approximately 35 (or more) words per minute and file accurately
  • Maintains strict confidentiality with all information and records
  • Is consistently at work and on time; arrives at meetings and appointments on time
  • Basic working knowledge of computers and/or experience with computers
  • Ability to write routine correspondence; ability to speak effectively before employees of the organization and with insurance companies or patients as needed
  • Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions
  • Balances team and individual responsibilities
  • Demonstrates analytical and planning skills
  • Ability to effectively lead and mentor the staff with daily expectations and requirements
  • Must be dependable, enthusiastic, and have multitasking abilities; must be a self-starter
  • Must have proficient computer skills
  • Ability to verbally communicate thoughts clearly, to read, to write, to file accurately, and to remember information
  • Ability to communicate effectively and appropriately (verbally and in writing) while maintaining rapport with employees, clinicians, hospital partners, vendors, and customers
  • Ability to interact effectively at all levels
  • Ability to be detail-oriented
  • Mathematical ability to add, subtract, multiply, and divide
  • Must be able to work effectively both independently and with others
  • Ability to lift 30 pounds or less

Education & Experience Requirements:

The above knowledge, skills, and abilities may be demonstrated by an individual with a high school diploma or general education degree (GED); one to two year of credentialing experience or a Certified Provider Credentialing Specialist (CPSC) or (CMSC) designation preferred.

Job Type: Full-time