Credentialling Coordinator

Provider Support Service Coordinator

At OrthoCarolina, our team is our greatest asset and the foundation of our success. We are a diverse group of individuals, accountable to each other to uphold the standards of excellence and promote an environment of teamwork throughout the organization. OrthoCarolina has 43 unique care locations with over 1300 professionals who share a common goal to make lives better. Our employees are eligible for a full spectrum of benefits including paid company holidays, wellness programs, and tuition reimbursement.

OrthoCarolina is seeking a qualified professional to join our team as a Provider Support Service Coordinator.

The Provider Support Services Coordinator ensures all applications for initial appointment, reappointments and privileges of medical providers (physicians, physician assistants, therapists, organization, clinics, DME, etc.) for appropriate hospitals, managed care organizations and malpractice insurance coverage are completed and processed in a timely manner. This position also maintains licensure (including medical license, DEA and privilege license) for physicians, physician assistants and clinics and current documentation on medical providers for hospitals and participating managed care organizations.

Essential Functions:

• Coordinates credentialing/re-credentialing process by maintaining communication and assistance with other OrthoCarolina employees, hospital medical staff departments, representatives from managed care organizations and malpractice underwriter by gathering appropriate credentialing and re-credentialing information such as signatures and documents.
• Maintains current credentialing files of medical providers to include state licensure, DEA, certificate of insurance, board certification and CME's.
• Notifies Business Office representative of participation, terminations and changes for managed care database maintained. Maintains a current confidential database of physicians and physician assistants state licensure and DEA's located on S: drive for clinical and triage staff use only.
• Renews state license and DEA for physicians, fellows and physician assistants. Maintains an Excel spreadsheet for tracking renewal dates.
• Assists new physicians and physician assistants in scheduling hospital orientations and interviews necessary to obtain hospital privileges.
• Renews North Carolina Department of Revenue Privilege License for all physician's and fellows, annually.
• Responsible for written notification to hospitals, managed care organizations and malpractice carrier of all provider, clinic, and organization changes/terminations.

Skills

Communication, Customer Service, Data Entry, Health Insurance, Patient Care Documentation, Scheduling, Teamwork, Time Management