CVO Coordinator, Credentialing

University Hospitals; Cleveland (OH); On-site; USD 60,000 - 90,000; Full time

Job summary

University Hospitals is seeking a CVO Coordinator, Credentialing, to oversee the initial credentialing process and analyze primary source verification data. You will ensure data integrity within the credentialing database and support onboarding and training of team members.

Responsibilities include auditing files, maintaining standards compliance with Joint Commission, CMS and NCQA, and contributing to new system modules and workflows.

Qualifications

• Bachelor's degree required or 3 years direct credentialing experience in lieu of degree.
• 3+ years of experience in a similar credentialing role, preferably in healthcare.
• NAMSS CPCS and/or CPMSM certification required within 5 years.

Responsibilities

• Oversee initial credentialing processes and analyze primary source verification data.
• Ensure compliance with Joint Commission, CMS, NCQA, and other standards.
• Train and onboard new team members; participate in development of new technologies and database modules.
• Audit initial appointment files and ensure records are properly set up in credentialing systems.
• Maintain data quality and integrity in web-based credentialing applications.

Skills

Analytical skills

Verbal & writing skills

PHI handling

Critical thinking

Organizational skills

Attention to detail

Interpersonal communication

Time management

Education

Bachelor's Degree

3 years credentialing experience (in lieu of degree)

Tools

Microsoft Office

Adobe Acrobat Pro

Credentialing database software

Job description

Job Description - CVO Coordinator, Credentialing (2600097S)

A Brief Overview

The CVO Coordinator is responsible for oversight of the initial credentialing process and analyzing and evaluating primary source verification data and documents. This position is involved in data entry and integrity within the credentialing database. Under the supervision of the CVO Manager, the CVO Coordinator functions as an agent of the protected peer review process and completes functions related to enterprise credentialing information management.

What You Will Do

• Analyzes and processes initial applications by utilizing independent critical thinking skills, which may involve extensive investigative review and interpretation
• Maintains current knowledge of and adheres to hospital and outside accreditation and regulatory standards (Joint Commission, Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), etc.)
• Serves as a content expert and participates in onboarding and training of new team members
• Utilizes current trends and practices in all aspects of credentialing
• Assists with initial credentialing projects as assigned
• Manages data quality and integrity for web-based applications based on defined standards through systematic audits
• Analyze and manage data maintained in system credentialing database following strict data standards
• Manage all pending staff database records
• Assist in the integration of new hospital acquisitions, including setting up staff records in MSOW, organizing scanned files, training new team members
• Assist CVO System Manager with creation of electronic work processes in the credentialing database
• Participate in the development of new technologies, database modules, and upgrade testing
• Audit all initial appointment files of newly credentialed providers and status/privilege changes ensuring all requirements are met and set up the practitioner records in the credentialing database which feed multiple downstream systems

Additional Responsibilities

• Participate in the development of new technologies, database modules, and upgrade testing
• Performs other duties as assigned.
• Complies with all policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Education

• Bachelor's Degree (Required) or
• Three (3) years of direct credentialing experience accepted in lieu of bachelor's degree.

Work Experience

• 3+ years of experience working in a similar role, preferably in a healthcare setting (Required) and
• 2+ years of experience with database utilization and data management (Required)

Knowledge, Skills, & Abilities

• Strong analytical and quantitative skills (Required proficiency)
• Advanced verbal, writing and editorial skills (Required proficiency)
• Attentive listening skills (Required proficiency)
• Confidence interacting with UH Senior Leaders, Physicians, Board Members, and outside agencies (Required proficiency)
• Critical thinking skills, which result in making independent procedural decisions and judgments (Required proficiency)
• Skill in establishing priorities with independent coordination of day-to-day activities (Required proficiency)
• Demonstrated knowledge of medical terminology (Required proficiency)
• Excellent communication and organizational skills (Required proficiency)
• Ability to work in a fast-paced environment (Required proficiency)
• Ability to multi-task (Required proficiency)
• Excellent computer skills, including knowledge of Microsoft applications, knowledge of Adobe Acrobat Professional and credentialing database experience (Required proficiency)
• Work experience in performing process, operational and system audits (Required proficiency)
• Analytical thinker, organized, attention to detail is essential (Required proficiency)

Licenses and Certifications

• NAMSS CPCS and/or CPMSM certification (Required within 5 Years)

Physical Demands

• Standing Occasionally
• Walking Occasionsally
• Sitting Constantly
• Lifting Rarely up to 20 lbs
• Carrying Rarely up to 20 lbs
• Pushing Rarely up to 20 lbs
• Pulling Rarely up to 20 lbs
• Climbing Rarely up to 20 lbs
• Balancing Rarely
• Stooping Rarely
• Kneeling Rarely
• Crouching Rarely
• Crawling Rarely
• Reaching Rarely
• Handling Occasionally
• Grasping Occasionally
• Feeling Rarely
• Talking Constantly
• Hearing Constantly
• Repetitive Motions Frequently
• Eye/Hand/Foot Coordination Frequently

Travel Requirements

• 5%