Hospital Credentialing Coordinator- Medical Administration- Remote

VCU Health; United States; Remote; USD 10,000 - 60,000; Full time

Job summary

An established industry player is looking for a Credentialing Coordinator to oversee the credentialing process for healthcare professionals. This role involves managing initial and re-credentialing applications, ensuring compliance with regulations, and interacting with clinicians to gather necessary documentation. The ideal candidate will have a strong background in credentialing, exceptional organizational skills, and the ability to work independently in a fast-paced environment. This position offers the flexibility of remote work while requiring candidates to be local to Virginia or nearby states, making it an exciting opportunity for those passionate about healthcare administration.

Qualifications

• 3+ years of credentialing experience in a hospital or managed care setting.
• Strong organizational skills and attention to detail are critical.

Responsibilities

• Manage all aspects of initial credentialing and re-credentialing for clinicians.
• Ensure compliance with hospital bylaws and local, state, and federal requirements.

Skills

Credentialing Experience

Organizational Skills

Attention to Detail

Communication Skills

Problem Solving

Education

Associates or Bachelors Degree

Degree in Business or Healthcare

Tools

Microsoft Office (Access, Word, Excel)

Credentialing Software

Job description

This is a remote position that requires candidates be local to Virginia

We are seeking an experienced professional in credentialing who specifically has at least 3 years of experience in hospital credentialing. This experience should include processing initial and reappointment applications with a focus on assessing privileges.

Responsibilities:

1. The Credentialing Coordinator is responsible for all aspects of the initial credentialing, re-credentialing, and privileging functions for all clinicians on medical and allied health staff at the VCU Health System Hospitals.
2. Interacting with clinicians to obtain applications and pertinent documents, evaluating data for accuracy and completeness.
3. Monitoring receipt and follow-up responses ensuring timely and efficient processing.
4. Notifying the supervisor Director of any adverse, incomplete, or questionable data.
5. Working independently to assess situations, consider alternatives, and choose the appropriate course of action.
6. Demonstrating sound organizational ability and effectively setting priorities.
7. Maintaining strict confidentiality and professional discretion.
8. Ensuring compliance with hospital bylaws and with local, state, and federal requirements.
9. Providing assistance to the Director in development, planning, organization, and control of the operation of the Medical Staff Office.
10. Attending medical staff committee meetings as directed.
11. Interacting and providing support services to medical staff officers, departments, and chairs as assigned.

Licensure, Certification, or Registration Requirements for Hire:

• Certified Provider Credentialing Specialist (CPCS) preferred.

Experience REQUIRED:

• Minimum of three (3) years previous credentialing and medical terminology experience in a hospital or managed care credentialing setting.
• Previous experience using a personal computer and various applications, including Microsoft Office Access, Word, and Excel, and credentialing software.

Experience PREFERRED:

• Five (5) years of previous experience in credentialing in a healthcare environment.
• Previous experience with the application of JCAHO, URAC, and NCQA guidelines.
• Certified Professional in Medical Services Management (CPMSM).

Education/training REQUIRED:

• Associates or Bachelors degree or experience in lieu.

Education/training PREFERRED:

• Associates or Bachelors Degree in Business, Healthcare, or closely related field.

Independent action(s) required:

• Expresses ideas and exchanges information clearly and concisely.
• Demonstrates the ability to prioritize work assignments effectively and efficiently within the scope of the employee’s responsibility.
• Effective development of relationships with other members of the team (i.e., non-clinical personnel, etc.).
• Highly motivated individual with independent work habits.
• Organizational skills, proficiency in MS Office Access, Word, and Excel, and credentialing software, and numerous hospital databases with extreme attention to detail are critical indicators for success in this role.
• Ability to multi-task in a stressful and limited time-constrained environment.
• Must possess knowledge of local, federal, and state laws and regulations and JCAHO standards related to the position’s chief objective and demonstrate aptitude for compliance with VCUHS policies, procedures, and customer service philosophy.

Physical Requirements:

• Physical: Lifting 20-50 lbs.
• Activities: Prolonged standing, Frequent bending, Walking (distance), Reaching (overhead, extensive, repetitive).
• Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking.
• Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Able to adapt to frequent change.

This job can be remote but in-person is preferred. Candidates must live in Virginia, Tennessee, Florida, North Carolina, or Maryland to work remote.

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.