CREDENTIALING COORDINATOR

CREDENTIALING COORDINATOR JOB SUMMARY The Credentialing Coordinator is responsible for the day to day processes for both FTCA/HRSA and payer Credentialing and Privileging programs of Comprehensive Community Health Centers. Ensures timely and accurate Credentialing and Privileging of all CCHC physicians and non-physician licensed professionals. The Credentialing Coordinator is responsible for maintaining the credentialing database platform. CREDENTIALING COORDINATOR ESSENTIAL DUTIES AND RESPONSIBILITIES Coordinates and administers the Credentialing and Privileging process for all CCHC providers and non-physician licensed professionals. Maintain the Credentialing database platform. Coordinates compliance for legal and regulatory documentation for the professionals of CCHC. Monitors accuracy of policies and procedures, ensuring compliance with accrediting organization requirements. Create CAQH profiles for providers. Responsible for ensuring that all providers are contracted with different payers, including HMO's, Medi-Cal and Medicare. Coordinate with the payer to ensure that all Credentialing requirements are met. Submit Credentialing forms and applications to IPA’s, Medical Groups and Plans as needed. Follow-up on submitted applications with IPA’s, Medical Groups and Plans. Functions as a credentials and privileging contact for all internal and external inquiries. Assist in developing innovative tools, features, and work flows to improve the Credentialing and Privileging processes. Works closely with HR to obtain all necessary documents for Credentialing and Privileging. Performs miscellaneous job-related duties as assigned. CREDENTIALING COORDINATOR EDUCATION AND EXPERIENCE Bachelor’s in a health-related field preferred. Credentialing knowledge and familiarity with industry standards required. Knowledge of Community Health Centers (CHC) and HRSA clinical staffing requirements preferred CREDENTIALING COORDINATOR KNOWLEDGE, SKILLS AND ABILITIES Ability to find solutions when barriers are identified. Strong documentation skills. Ability to multi-task and prioritize when needed. Ability to independently seek out resources and work collaboratively. Ability to read, understand and follow oral and written instructions. Experience and work ethics that supports working within a high functioning, team-oriented environment. Demonstrates a willingness and ability to work under supervision. Ability to develop and maintain good working relationships with staff. Ability to use computer and learn new software programs. Excellent interpersonal skills reflecting clarity and diplomacy and the ability to communicate accurately and effectively with all levels of staff and management. Demonstrates ability to work in a regulatory climate that includes oversight of state and federal entities, payer contracts etc. Possesses ability to communicate effectively, both verbally and in writing. Possesses genuine respect for others and acceptance of their individual social and cultural traits. Proficient knowledge of Microsoft Outlook. Able to travel and attend professional meetings, conferences, trainings and clinic sites. Demonstrate flexibility, enthusiasm, and willingness to cooperate while working with others in multi-disciplinary teams. Performs other related duties as assigned. CREDENTIALING COORDINATOR PAY RATE: $25-$27/hr CREDENTIALING COORDINATOR BENEFITS: Medical, Dental and Vision – 100% paid by Employer Life Insurance and Accidental Dismemberment – 100% paid by Employer Paid Holidays Paid Time Off Wellness Day Off 401(k) and 401(k) matching Flexible Spending Account Fringe Supplemental Insurance #J-18808-Ljbffr