Remote Credentialing Specialist for Physicians & APPs

Grady Health System; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Grady Health System in the Atlanta area seeks a Credentialing Coordinator to manage initial credentialing and recredentialing of physicians and advanced practice providers. You will gather data from primary sources and ensure compliance with TJC, NCQA, and federal requirements.

The role requires independent processing, attention to detail, confidentiality, and collaboration with Medical Staff Services and service chiefs. Experience with managed care contracts and provider files is essential.

Qualifications

• Three years of credentialing/privileging experience in a hospital or managed care setting and/or Medical Staff Services.
• Two years of database experience.
• Three years minimum in progressively responsible positions in a complex business/administrative office setting, which includes working with physicians, advanced practice providers or other professional groups

Responsibilities

• Communicates completion of applications to Medical Staff Services Director and appropriate review by Service Chiefs.
• Assists with FPPE and OPPE collection.
• Coordinates the credentialing/ privileging process for assigned physicians and advanced practice providers
• Acts independently to process credentialing/ privileging applications for physicians and advanced practice providers.
• Maintains thorough understanding of TJC, NCQA and state/federal regulatory credentialing/privileging standards.
• Responsible for the quality and integrity of provider files and meets processing quality and productivity standards.
• Performs routine file audits. Serves as a liaison for physicians and advanced practice providers navigating through the health system.
• Adheres to strict confidentiality requirements
• Analyzes provider applications for completeness, accuracy, consistency, gaps in work history, relevant references, etc.
• Verifies all credentialing/privileging elements, including but not limited to, education, training, board certification, work history, licensure and certifications, case/procedure logs, malpractice coverage, etc through a variety of primary sources as deemed appropriate per TJC standards and other applicable accrediting agencies.
• Identifies/concerns issues and initiates further data collection as needed.
• Initiates appropriate and timely follow-up information from the Medical Staff Services Department or other sources as needed.

Skills

Credentialing experience

Database experience

Education

Diploma

Tools

Database systems

Job description

Grady Health System in the Atlanta area seeks a Credentialing Coordinator to manage initial credentialing and recredentialing of physicians and advanced practice providers. You will gather data from primary sources and ensure compliance with TJC, NCQA, and federal requirements.

The role requires independent processing, attention to detail, confidentiality, and collaboration with Medical Staff Services and service chiefs. Experience with managed care contracts and provider files is essential.