Credentialing Coordinator I Nonexempt

AdventHealth Altamonte

United States

On-site

USD 40,000 - 74,000

Full time

14 days+

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Benefits offered by this job

Medical insurance
Dental insurance
Vision insurance
Life insurance
Disability insurance
Paid time off
403-B retirement plan
Parental leave
Career development
Well-being resources
Mental health resources
Pet benefits

Job summary

AdventHealth Altamonte in Tampa, FL is seeking a Credentialing Specialist to populate, update, and verify credentialing data across hospital sites. You will coordinate administrative tasks, perform primary source verifications, and respond to inquiries within policy, ensuring timely and accurate credentialing records.

You will generate tracking reports, maintain confidentiality, and support leadership with project coordination while upholding AdventHealth's mission and compliance standards.

Qualifications

  • 3+ years in medical staff services, CVO, managed care credentialing or healthcare related experience.
  • Associate degree preferred; high school diploma required.
  • CPCS/CPMSM certifications preferred.
  • Spanish language skills preferred.

Responsibilities

  • Populate, update, and verify credentialing data for applicants across hospital sites.
  • Coordinate and provide admin support for credentialing processing per policies.
  • Perform verifications and respond to inquiries within policy.
  • Prepare client advisory reports and tracking reports to meet deadlines.
  • Maintain confidentiality and communicate with stakeholders as required.

Skills

Medical staff services
Communication skills
Interpersonal skills
Team collaboration
Analytical thinking
Confidentiality

Education

Associate degree
High School diploma
Healthcare field study

Tools

MS Office
Image Now
Payroll systems

Job description

Our promise to you:


Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.


All the benefits and perks you need for you and your family:


  • Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

  • Paid Time Off from Day One

  • 403-B Retirement Plan

  • 4 Weeks 100% Paid Parental Leave

  • Career Development

  • Whole Person Well-being Resources

  • Mental Health Resources and Support

  • Pet Benefits


Schedule:

Full time


Shift:

Day (United States of America)


Address:

3100 E FLETCHER AVE


City:

TAMPA


State:

Florida


Postal Code:

33613


Job Description:

Populates, updates, and verifies the correctness and completeness of database information on an ongoing basis. Coordinates and provides administrative support for processing, verifying, and maintaining credentialing information for new applicants and re-applicants to all hospital sites. Performs and tracks primary source and other required verifications for all applicants according to established policies and procedures. Responds to customer inquiries and resolves problems within established policies and procedures. Prepares and provides client advisory reports, including status reports, expired items reports, and completed file reports to meet contractual time frames. Uses critical thinking skills to flag incongruent issues or information during credentialing and data entry tasks. Manages the integrity of the credentialing database and appropriateness of hard copy information received and provided to contracted entities. Produces tracking reports to detect and resolve work in process issues. Provides departmental administrative support to leadership in carrying out activities and coordinates completion of related projects. Supports the health system mission, values, and philosophy, maintaining adherence to professional confidentiality standards. Ensures information is maintained confidentially as required by local, state, and federal law. Maintains ongoing communication and feedback with all stakeholders, customers, and staff. Performs other duties as assigned.


Knowledge, Skills, and Abilities:


  • Demonstrated experience in effectively providing medical staff services and support. [Required]

  • Ability to communicate (verbal/written) effectively at different levels of the organization. [Required]

  • Demonstrated interpersonal skills and ability to support and work in collaboration with multiple sites as needed. [Required]

  • Professional demeanor, business acumen, political astuteness, adaptability, and diplomacy combined with the ability to establish and maintain collaborative relationships across the organization. [Required]

  • Demonstrated client management skills including customer service and physician relations. [Required]

  • Team oriented with a high degree of initiative; a self-starter with demonstrated data entry, administrative skills, and proficiency in payroll, accounts payable, and accounts receivable. [Required]

  • Highly detail-oriented and organized with analytical and critical thinking skills. The ability to produce and proof reports and type correspondence is essential. [Required]

  • Results driven with the ability to effectively multi-task, manage conflicting priorities, and function in demanding, stressful, and fast-paced confidential environments. [Required]

  • Computer skills and proficiency in MSOffice (Word, Excel, Access, PowerPoint, Outlook), document imaging (i.e., fax, scanner, Image Now), and knowledge of healthcare, hospital/provider operations, and managed care payer operations. [Required]

  • General knowledge of healthcare, hospital and provider operations, managed care payer contracts and operations, NCQA requirements for delegated credentialing, CAQH, and MD Staff and/or other systems used to determine provider medical privileges. [Preferred]

  • Prior experience in credentialing, privileging, practitioner database management, insurance (governmental and 3rd Party Payers), and additional language skills (i.e., Spanish) is preferred.


Education:


  • Associate [Preferred]

  • High School Grad or Equiv [Required]


Field of Study:


  • in Healthcare related field


Work Experience:


  • 3+ in medical staff services, CVO, managed care credentialing or healthcare related experience [Required]


Additional Information:


  • N/A


Licenses and Certifications:


  • Certified Provider Credentialing Specialist (CPCS) [Preferred]

  • Certified Professional Medical Staff Management (CPMSM) [Preferred]


Physical Requirements:

Physical Requirements – https://tinyurl.com/23km2677


Pay Range:


  • $19.22 – $35.75


Background Screening Requirement (Florida Law)


  • Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

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