[Hiring] Credentialing Coordinator I @Geisinger
Role Description
Conducts background investigations on physicians and other providers applying for affiliation including:
• Licensure
• Education and post-graduate clinical training
• Board certification
• Disciplinary actions and other professional sanctions
• Malpractice history
• Peer assessment of current competence at time of appointment, reappointment, and cross credentialing
Job Duties include:
• Reviews and analyzes physician applications and credentialing documents.
• Assesses completeness of information and providers' qualifications relative to established standards.
• Reviews and analyzes primary source verification for licensure, certification or registration required to practice a profession.
• Requests, maintains, and ensures competency data is present at appointment and re-appointment.
• Maintains tracking of all new provider's drug screening, background checks, child abuse clearance, finger printing, code of conduct, disruptive practitioner policies, current clinical competency data and Health Service information for new providers.
• Immediately reports to manager any collected information which may be adverse to an applicant.
• Identifies and flags adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for credentialing review.
• Maintains a working knowledge of applicable regulatory agencies.
• Maintains an understanding of the third-party payor requirements.
• Prepares and screens, mails letters, tracks and responds daily.
• Employs public relations skills in a wide variety of phone contacts with external sources for purposes of soliciting information essential to credentials investigations.
• Organizes and maintains physician files and information following confidentiality guidelines.
• Internally audits and maintains physician files in accordance with established principles of legal documentation and confidentiality.
• Prepares all files monthly for Credentials Committee review and follows up on Credentials Committee Decisions.
• Establishes and maintains excellent relationships and good communication channels with physicians, office staff, and practice administrators.
• Assists with special projects (i.e., physician education, JCAHO and Department of Health Preparation, clinical competency data, life supports).
• Prioritizes to meet deadlines on daily work and special projects.
• Maintains a thorough understanding of the standards of JCAHO, Department of Health, Bylaws, Rules and Regulation of the Medical Staff, and other regulatory agencies as appropriate.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.
Qualifications
• High School Diploma or Equivalent (GED) - Required
• Minimum of 2 years experience in Healthcare - Required
Requirements
• Skills: Communication, Computer Literacy, Credentialing, Professional Presentation, Working Independently
Benefits
• Healthcare benefits for full-time and part-time positions from day one, including vision and dental.
• Encouragement of an atmosphere of collaboration, cooperation, and collegiality.
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Conducts background investigations on physicians and other providers applying for affiliation including:
• Licensure
• Education and post-graduate clinical training
• Board certification
• Disciplinary actions and other professional sanctions
• Malpractice history
• Peer assessment of current competence at time of appointment, reappointment, and cross credentialing
Job Duties include:
• Reviews and analyzes physician applications and credentialing documents.
• Assesses completeness of information and providers' qualifications relative to established standards.
• Reviews and analyzes primary source verification for licensure, certification or registration required to practice a profession.
• Requests, maintains, and ensures competency data is present at appointment and re-appointment.
• Maintains tracking of all new provider's drug screening, background checks, child abuse clearance, finger printing, code of conduct, disruptive practitioner policies, current clinical competency data and Health Service information for new providers.
• Immediately reports to manager any collected information which may be adverse to an applicant.
• Identifies and flags adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for credentialing review.
• Maintains a working knowledge of applicable regulatory agencies.
• Maintains an understanding of the third-party payor requirements.
• Prepares and screens, mails letters, tracks and responds daily.
• Employs public relations skills in a wide variety of phone contacts with external sources for purposes of soliciting information essential to credentials investigations.
• Organizes and maintains physician files and information following confidentiality guidelines.
• Internally audits and maintains physician files in accordance with established principles of legal documentation and confidentiality.
• Prepares all files monthly for Credentials Committee review and follows up on Credentials Committee Decisions.
• Establishes and maintains excellent relationships and good communication channels with physicians, office staff, and practice administrators.
• Assists with special projects (i.e., physician education, JCAHO and Department of Health Preparation, clinical competency data, life supports).
• Prioritizes to meet deadlines on daily work and special projects.
• Maintains a thorough understanding of the standards of JCAHO, Department of Health, Bylaws, Rules and Regulation of the Medical Staff, and other regulatory agencies as appropriate.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.
Qualifications
• High School Diploma or Equivalent (GED) - Required
• Minimum of 2 years experience in Healthcare - Required
Requirements
• Skills: Communication, Computer Literacy, Credentialing, Professional Presentation, Working Independently
Benefits
• Healthcare benefits for full-time and part-time positions from day one, including vision and dental.
• Encouragement of an atmosphere of collaboration, cooperation, and collegiality.
Apply tot his job
Apply To this Job