St. Joseph’s/Candler Health System
Coordinator, System Credentialing
St. Joseph’s/Candler Health System, New York, New York, United States
The Credentialing Coordinator adheres to industry and SJ/C established credentialing guidelines and completes in-depth review and analytics of provider applications and accompanying documents to successfully facilitate the process of ensuring provider meets the requirements of SJ/C, Network and Medical Staff for initial, recredentialing, demographic and other elements of provider credentialing delivering the highest level of accuracy, timeliness and effectiveness of the credentialing and enrollment process.
Education Bachelors in Healthcare or Business - Preferred
Experience 3-5 Years healthcare experience - Required
Credentialing experience and medical terminology - Preferred
Knowledge of Joint Commission, NCQA ad AMA credentialing standards - Preferred
License & Certification NAMSS, AAPC or Institute for Credentialing Excellence Certification as a Credentialing Specialist or Credentialing Coordinator -Preferred
Must be successfully attained within 12-months of entering the position and successfully maintained annually.
Core Job Functions Verifies competence, medical and professional education, residency, internships, fellowships, additional training, board certifications, healthcare affiliations, work history, military experience, processional references, licensure and certifications, DEA and Controlled Substance as applicable, malpractice coverage and privileges the applicant is requesting.
Completes all plan enrollment for applicable providers as well as maintaining a detailed status report throughout the process tracking the credentialing and enrollment to ensure exceptional communication internally and externally.
Compiles all information for credentialing committee meetings coordinating through the Manager of Credentialing and Network Services and Director of Managed Care and Market Relations. Prepares and submits all reports to Administration timely for inclusion in the Board of Trustee report.
Maintains a working knowledge of Hospital, Network and Medical Staff Bylaws and Policies and Procedures as they related to the provider credentialing and enrollment process.
Provider applications are distributed and processed in a compliant manner. Files are presented to Credentialing Committee and/or Chairperson or action in a timely manner and provider notification letters are distributed within one week of approval.
Not the right fit? Join our Professional Talent Network and learn more about allcurrent and future job opportunities.
Learn more about the many benefits available to SJ/C co-workers. From wellness programs and insurance options to child care and housing opporunities, SJ/C invests in the health and well-being of our co-workers in many ways. Click here to learn more.
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Education Bachelors in Healthcare or Business - Preferred
Experience 3-5 Years healthcare experience - Required
Credentialing experience and medical terminology - Preferred
Knowledge of Joint Commission, NCQA ad AMA credentialing standards - Preferred
License & Certification NAMSS, AAPC or Institute for Credentialing Excellence Certification as a Credentialing Specialist or Credentialing Coordinator -Preferred
Must be successfully attained within 12-months of entering the position and successfully maintained annually.
Core Job Functions Verifies competence, medical and professional education, residency, internships, fellowships, additional training, board certifications, healthcare affiliations, work history, military experience, processional references, licensure and certifications, DEA and Controlled Substance as applicable, malpractice coverage and privileges the applicant is requesting.
Completes all plan enrollment for applicable providers as well as maintaining a detailed status report throughout the process tracking the credentialing and enrollment to ensure exceptional communication internally and externally.
Compiles all information for credentialing committee meetings coordinating through the Manager of Credentialing and Network Services and Director of Managed Care and Market Relations. Prepares and submits all reports to Administration timely for inclusion in the Board of Trustee report.
Maintains a working knowledge of Hospital, Network and Medical Staff Bylaws and Policies and Procedures as they related to the provider credentialing and enrollment process.
Provider applications are distributed and processed in a compliant manner. Files are presented to Credentialing Committee and/or Chairperson or action in a timely manner and provider notification letters are distributed within one week of approval.
Not the right fit? Join our Professional Talent Network and learn more about allcurrent and future job opportunities.
Learn more about the many benefits available to SJ/C co-workers. From wellness programs and insurance options to child care and housing opporunities, SJ/C invests in the health and well-being of our co-workers in many ways. Click here to learn more.
#J-18808-Ljbffr