Credentialing Coordinator: Ensure Provider Privileges

Grady Health System; Atlanta (GA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health & Wellness benefits

Tuition reimbursement

Paid time off

Job summary

Grady Health System in Atlanta seeks a Credentialing Coordinator to manage initial and recredentialing for physicians and advanced practice providers, ensuring compliance with TJC, NCQA and state/federal standards.

The role requires independent data gathering and analysis, maintaining provider files, and coordinating FPPE/OPPE, with strong confidentiality and collaboration across Medical Staff Services.

Qualifications

• Three years credentialing/privileging experience in a hospital or managed care setting
• Two years database experience
• OR three years minimum in progressively responsible positions in a complex business/administrative office setting with physicians/APPs

Responsibilities

• Communicates completion of applications to Medical Staff Services Director and appropriate review by the Service Chiefs
• Assists with FPPE and OPPE collection
• Coordinates the credentialing/ privileging process for assigned physicians and advanced practice providers
• Acts independently to process credentialing/ privileging applications for physicians and advanced practice providers
• Maintains thorough understanding of TJC, NCQA and state/federal regulatory credentialing/privileging standards
• Responsible for the quality and integrity of provider files and meets processing quality and productivity standards
• Performs routine file audits. Serves as a liaison for physicians and advanced practice providers navigating through the health system
• Adheres to strict confidentiality requirements
• Analyzes provider applications for completeness, accuracy, consistency, gaps in work history, references, etc
• Verifies all credentialing/privileging elements through primary sources as deemed appropriate per standards
• Identifies concerns/issues and initiates further data collection as needed
• Initiates appropriate and timely follow-up information from the Medical Staff Services Department or other sources as needed

Skills

Credentialing

Data analysis

Attention to detail

Regulatory compliance

Interpersonal communication

Education

Associate degree

Tools

Database management

Job description

Grady Health System in Atlanta seeks a Credentialing Coordinator to manage initial and recredentialing for physicians and advanced practice providers, ensuring compliance with TJC, NCQA and state/federal standards.

The role requires independent data gathering and analysis, maintaining provider files, and coordinating FPPE/OPPE, with strong confidentiality and collaboration across Medical Staff Services.