Credentialing Coordinator, Medical Staff - (Full-time, Remote)

Virtua; United States; Remote; USD 45,000 - 75,000; Full time

Job summary

An established industry player is seeking a dedicated Credentialing Coordinator to join their team. In this pivotal role, you will ensure the smooth processing of applications for medical staff, maintaining compliance with regulatory standards. Your expertise will help uphold the quality of care within the organization, while your strong communication and organizational skills will facilitate collaboration across departments. This position offers a unique opportunity to contribute to a health system recognized for its commitment to patient care and community wellness, all while working in a fully remote environment. If you are passionate about making a difference in healthcare, this role is perfect for you.

Qualifications

• 2+ years of credentialing or related experience required.
• Knowledge of provider enrollment and regulatory requirements essential.

Responsibilities

• Coordinate credentialing of applicants for membership and reappointment.
• Maintain Medical Staff documents to ensure compliance.
• Monitor proctoring process and maintain enrollment database.

Skills

Credentialing experience

Customer service

Communication skills

Organizational skills

Proficiency in Word

Proficiency in Excel

Proficiency in PowerPoint

Education

High School diploma

College degree

Job description

At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between - we are your partner in health devoted to building a healthier community.

If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.

In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics.

Location:

100% Remote (Candidates from AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only)

Employment Details:

• Type: Employee
• Classification: Regular
• Time: Full time
• Shift: 1st Shift (United States of America)
• Weekly Hours: 40

Additional Location:

Marlton, NJ

Job Summary:

Coordinate the credentialing of applicants for membership and reappointment in compliance with defined schedules. Collect and analyze information thoroughly to identify potential quality of care issues, behavioral problems, and appropriate education and training. Prepare and manage credentialing and re-credentialing applications for completeness and accuracy, maintain and monitor steps of the enrollment and re-enrollment process. Maintain an accurate enrollment database, coordinate flow of information between Credentialing Services, Revenue, and Billing departments. Investigate issues of concern, generate reports, and present findings to facilitate recommendations to the Board of Trustees.

Position Responsibilities:

1. Process applications, including those from Allied Health professionals, for initial appointment and reappointment for Provider Enrollment Plans to the medical staff of multiple Virtua entities, in a timely manner.
2. Maintain required Medical Staff documents to ensure compliance, including FPPE and OPPE for medical staff through appointment and reappointment process.
3. Prepare Committee agenda and supporting material with Committee Chair. Attend meetings, record minutes, and ensure prompt follow-up on actions taken by the Committee. Review "Board Actions Summary" from NJ and provide follow-up as necessary.
4. Monitor proctoring process, including data collection, analysis, and report generation from credentialing database to ensure compliance with policies and procedures. Maintain and audit provider status in the enrollment database.
5. Coordinate flow of information between Medical Staff, Administration, and other hospital departments. Initiate problem solving of departmental roadblocks and regulatory issues.
6. Demonstrate knowledge of Medical Staff Bylaws, policies, procedures, and external accrediting agencies such as JCAHO, NCQA, as well as state and federal agencies.
7. Participate in project functions, assist team members, and complete other duties to support Provider Enrollment success.

Qualifications:

Required Experience: 2 years of Credentialing or related experience. Knowledge of provider enrollment and regulatory requirements (NCQA, DOH, Joint Commission). Strong customer service, communication, organizational skills, and ability to work independently. Proficiency in Word, Excel, PowerPoint.

Education: High School graduate; College degree preferred.

Certifications: Certification by the National Association of Medical Staff Services (CPMSM or CPCS) preferred. CMSC preferred.