Credentialing Coordinator

Credentialing Coordinator

Fully Remote • USA Remote - Nashville, TN 37203

Description

HealthStream is the leader in healthcare workforce solutions. We help organizations work better by helping their people work smarter.

HealthStream provides the leading learning, clinical development, credentialing, and scheduling applications delivered on healthcare's #1 platform. We streamline everyday tasks while improving performance, engagement, and safety – fostering a workplace where people flourish, and care thrives.

Why Join Us

At HealthStream, you'll have the opportunity to make a meaningful impact on the future of healthcare by collaborating with a team of talented professionals dedicated to innovation and excellence. We offer competitive compensation, comprehensive benefits, and a supportive work environment where creativity and collaboration thrive.

Our shared vision is to enhance the quality of healthcare by empowering the people who deliver care – a commitment we have upheld for over 30 years through providing innovative solutions and driving constant growth. Join us in revolutionizing the healthcare industry and shaping the future of patient care. As a HealthStreamer, you will be at the forefront of healthcare technology innovation, making a recurring impact on the industry.

We're proud of our values-forward culture that offers our people:

• Mission-oriented work
• Diverse and inclusive culture
• Competitive compensation & bonuses
• Comprehensive insurance plans
• Mental and physical health support
• Work-from-home flexibility
• Fitness center reimbursements
• Streaming good time off for volunteering
• Wellness workshops
• Buddy program for new HealthStreamers
• Collaborative work environment
• Career growth opportunities
• Continuous learning opportunities
• Inspiring workspaces to collaborate and connect with other HealthStreamers
• Free employee parking at our resource centers in Nashville and San Diego

At HealthStream, our thriving culture encourages collaboration and values contributions, allowing our team members to continuously solve big problems and grow. We offer flexibility and paid time off to support work-life integration for all employees, including a hybrid work environment and Streaming Good volunteer day. For team members in commutable distance, HealthStream has resource centers in Nashville, TN and San Diego, CA. Our resource centers provide an inspiring workspace to collaborate and recharge as well as company-sponsored onsite social events for development, connection, and celebration.

We are committed to driving innovation in healthcare and ensuring that patients receive competent care from qualified professionals. As a HealthStream team member, you will help bring this vision to life. If you want to work for a company committed to its values and vision, HealthStream is the place for you!

HealthStream is an equal opportunity employer. HealthStream prohibits employment practices that discriminate against individual employees or groups of employees on the basis of age, color, disability, national origin, race, religion, sex, sexual orientation, pregnancy, veteran or military status, genetic information or any other category deemed protected by state and/or federal law.

Position Information

Position Overview

Supports the CVO's application process, credentialing verification, expirable management and ongoing monitoring work for contracted healthcare organizations. Ensures clients and providers have a positive experience by providing quality service and communication.

Key Responsibilities

• Coordinates provider application and primary source verification process using CVO credentialing platform.
• Manages provider application process including sending electronic applications to providers per client requests, evaluating the received application for completeness, resolving incomplete application information, accepting information into credentialing platform following CVO policies and procedures.
• Communicates with applicants and designated administrative support to resolve application requirements and incomplete data in a professional manner.
• Manages primary source verifications for provider applications including ensuring the verification of credentialing information from the provider's application is correct and from primary sources, tracking fees for verifications, following up on non-received verifications needed to close files, and tracks information following CVO policies and procedures.
• Communicates professionally with applicants, designated administrative support and primary source organizations on verification discrepancies, information needs and requirements.
• Manages ongoing expirables for providers primary state license, board certification, DEA/CDS and malpractice insurance for contracted clients.
• Manages ongoing monitoring of sanctions for contracted clients for state licenses, Medicare and Medicaid and Medicare Opt-Out. Provides a monthly report of outcomes.
• Stays informed on all client criteria requirements to ensure requirements are applied to files through the application and verification process.
• Communicates with providers and client questions and concerns regarding a variety of issues related to the processing of credentialing applications.
• Tracks and obtains fee verifications; follows department policies and procedures standards for check requests and credit card usage.
• Supports the billing process for verification services.
• Maintains and updates the database reference tables in accordance with internal policies and procedures with current contact information following data standardization protocols.
• Maintains own professional growth through participation in seminars, conferences, in-service programs and self-directed learning activities
• Contributes to the team efficiency by providing support both operationally and administratively.
• Assists with special projects and tasks as requested

Qualifications

Requirements

• Associate's degree preferred. In lieu of education requirement, previous work history and years of experience may be considered.
• 1-3 years job related experience, preferably in a provider credentialing environment, a provider network or medical group.
• General knowledge and understanding of healthcare regulatory agencies NCQA, JC and AAAHC.
• General knowledge of credentialing requirements as related to medical providers.
• General knowledge of the health care industry including hospital settings, physician practices, surgery centers and managed care organizations.
• Knowledge and experience in Microsoft Office applications.

Qualifications

• Computer proficiency and accuracy in data entry.
• Ability to organize and prioritize work and manage multiple priorities.
• Ability to work in a fast-paced environment.
• Applies data integrity standards to the entry of application information.
• Excellent attention to detail.
• Excellent organizational, analytical, and both oral and written communication skills.
• Competent in Microsoft Office, Teams, Word, Excel and Outlook.
• Strong written and verbal communication skills and competence to communicate effectively to internal and external customers.
• Sound judgment and decision-making skills.
• Understands and applies department policies and procedures associated with medical credentialing.
• Applies data integrity standards to application and verification information.
• Focus' on customer satisfaction; identifies opportunities for creating efficiencies or improvements.
• Dependable and a strong work ethic.
• Must be able to work well independently and exercise independent judgment.
• Must have the ability to understand and apply policies and procedures and regulatory standards associated with medical credentialing
• This position is primarily sedentary in a normal office environment.
• Extensive computer usage and use of the phone.
• Could lift up to 20 lbs.
• Accountability - Taking responsibility for one's actions and the consequences that result from those actions.
• Communication & Positive Presence - Listening attentively and respectfully; expressing thoughts and ideas effectively and concisely—both verbally and in writing. Exhibiting a pleasant attitude.
• Collaboration - Cooperating and working effectively with others in the pursuit of common goals.
• Problem Solving - Using sound judgment, logic, and common sense to identify and/or resolve issues that involve clients/customers, products, and processes.
• Adaptability - Being flexible and continuing to function effectively during times of change.
• Organizing - Using effective methods for tracking project details, time, and resources in order to complete tasks efficiently and in a timely manner.
• Quality Focus - Acting diligently to ensure all aspects of work are completed accurately.
• Customer Service - Treating clients/customers with a high level of respect and taking action in order to meet or exceed expectations and resolve problems.

Compensation

• The salary range for this position is $21.80 -$23.54 per hour. Salary will be determined on the candidate's level of experience and qualifications. Compensation will be commensurate with skills, relevant