CREDENTIALS COORDINATOR

CalvertHealth; Prince Frederick (MD); On-site; USD 50,000 - 75,000; Full time

Job summary

CalvertHealth seeks a Credentialing Coordinator to support all credentialing functions and meeting coordination within the Medical Staff Services Department.

You will process new and reapplications, verify credentials, and maintain credentialing software. The role ensures compliance with state, federal, and accreditation requirements and coordinates committee activities and schedules onsite.

Qualifications

• 3 years of related experience in credentialing or healthcare payer enrollment.
• Experience with credentialing in a healthcare setting is preferred.
• Maintains unit-specific competencies and required training per GA-057.
• Knowledge of medical terminology is helpful.

Responsibilities

• Support credentialing functions and meeting coordination within Medical Staff Services.
• Process and verify new applications and reapplications; maintain credentialing software access.
• Verify training, credentials, insurance, licensure and required documents; monitor expiration dates.
• Coordinate credentialing file review with department chairs and credentials committee; support minutes and agendas.

Skills

Credentialing

Healthcare experience

Attention to detail

Regulatory knowledge

Education

High School Diploma

Associates degree preferred

Tools

Credentialing software

Job description

Reports To

Medical Staff Services Coordinator/Director

Job Summary

Provides support for all credentialing functions and meeting coordination within the Medical Staff Services Department. Process and verify new applications and reapplications for the Medical Staff. Maintain and update credentialing software. provider access to EMR and other Hospital programs, intranet and other internal directories. Responsible for verifying proper training, credentials, insurance, certifications, licensure and any other credentialing document as required by state, federal and acrreditation requirements. Monitors license and credentials expiration dates and advise staff members of required “renew by” dates. Ensures that state, federal, and other regulations are met pertaining to credentialing requirements for all medical staff including Physicians, Podiatrists, Dentists, Telemedicine Providers and Advanced Practice Providers. Coordinates credentialing file review with department chairs & credentials committee members. Coordinate and support the Credentials Committee including creating the agenda, taking meeting minutes and presenting agenda items in a complete and organized manner. Conducts research on updated state and federal regulations and policies. Releases information to requesting agencies and public inquiries when required by law. Help develop internal credentialing processes. Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institution.

Education

Position requires a High School Diploma. Associates degree preferred.

Registration/Certification/Licensure

Certification preferred: CPMSM (Certified Professional in Medical Services Management), CPCS (Certified Provider Credentialing Specialist). If not currently certified, will consider credentialing or medical staff services experience.

Experience

Position requires a combination of 3 years of related experience. Credentialing experience working in a healthcare setting or payer enrollment setting is preferred.

Other Requirements

Maintains unit-specific and hospital competencies, mandatory learning, and any clinical certifications required in accordance with the Staff Education and Training policy GA-057 and/or any other department requirements. Experience with database programs desired. Ability to communicate effectively verbally and in writing. Ability to handle multiple tasks, work with interruptions and reprioritize often. Good interpersonal skills are necessary due to diverse customer group. Must be attentive to details. Knowledge of medical terminology is preferred. This is an in-person position that requires the candidate to be onsite per the required schedule. Telework is not accepted.

FLSA Status

Exempt