Credentialing Coordinator

Job Details:


Job Title: Credentialing Coordinator
Work Setting: Onsite
Location: St. Helena CA
Schedule: 5x8-hour days
Duration: 3 Months


Pay: $45/hr
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Job Summary:
• Coordinates and processes all medical staff applications for appointment/reappointment for assigned areas of responsibility according to established procedures.
• Coordinates the physician initial application and appointment process in accordance with Joint Commission standards and medical staff bylaws.
• Acts as a liaison between organization administration and the Medical Staff.
• Coordinates small programs with limited budget and organizational impact.

Requirements:
• Five years of relevant experience preferred.
• Healthcare industry experience preferred.
• Commercial healthcare experience preferred.

Required Certification:
• Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS).

Responsibilities:
• Initiates letters of inquiry regarding education, training, medical references, staff affiliations, board certifications, state licensure, and other relevant information.
• Requests verification from the Medical Board of California for current state licensure when applicable.
• Queries the National Practitioner Data Bank (NPDB).
• Creates confidential files for new practitioners and obtains copies of licenses and certifications as required.
• Conducts thorough background investigations, research, and primary source verification of all application components.
• Performs primary source verification through written correspondence, websites, telephone verification, and other approved sources.
• Follows up on incomplete or problematic information in a timely and consistent manner.
• Ensures reappointments are completed and reviewed by the appropriate credentialing entity before expiration.
• Tracks license and certification expirations to ensure timely renewals.
• Assists with annual reviews of Medical Staff Bylaws, rules, regulations, and related documents.
• Keeps current with legal and regulatory requirements affecting medical staff operations.
• Oversees provider information in online credentialing databases and systems.
• Performs other job-related duties as assigned.