Provider Credentialing Coordinator Jobs

Integrative Emergency Services, LLC ("IES") is looking for a Provider Credentialing Coordinator to work directly with hospital Medical Staff Offices (MSOs) to ensure providers secure and maintain privileges to work at assigned hospital facilities.

IES is dedicated to cultivating best practices in emergency care, providing comprehensive acute care services, creating value, and supporting patients, employees, clients, providers, and physicians in pursuit of the highest quality health care.

Essential Duties And Responsibilities

Include the following. Others may be assigned.

• Creates strong relationships with clients, providers, and Medical Staff Offices.
• Provides status updates for each assigned book of business daily in system dashboard.
• Coordinates with hospital, centralized verification service, medical staff, and clinicians to complete privileging process, including any additional documentation, references, and applications using consistent follow-up as necessary.
• Adhere to all company policies and procedures.
• Facilitates the State required collaborative agreement and APP supervision process.
• Maintains company database with current documentation, licensure and updated demographics.
• Complete CAQH applications for new and existing providers.
• Creates credential file and enters all pertinent credentialing information received from the provider initial and reappointment application. Uploads supporting documents to the document vault in the company database.
• Maintains accurate site rosters with current privileged providers at all times.
• Manages assigned book of business throughout the initial and reappointment process
• Complete government applications, commercial payer applications, and handle any corrections or rejections. Ensure enrollments are submitted on timely basis to avoid risk and held A/R.
• Monitor enrollment reports to track application submissions and revalidations.
• Ensures providers maintain all current licensure and certifications to remain active at hospitals.
• Coordinates file review for accuracy and prepares discrepancies for quality review and approval.
• Prepares provider credentialing files for required accountable care organizations.
• Support and lead hospital credentialing for any new clients.
• Researches and obtains verification of clinicians' medical experience, professional references, state licensure, DEA, DPS, etc.

Qualifications

Knowledge, Skills, Abilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to manage multiple priorities
• Ability to read, write and speak English proficiently
• Familiarity with databases
• Detail orientation
• Excellent interpersonal, organizational, and verbal/written communication skills
• High levels of proficiency with MS Office applications
• Strong customer service orientation
• Ability to use discretion appropriately and maintain confidentiality

Education / Experience: Include minimum education, technical training, and/or experience preferred to perform the job.

Required:

• High school diploma or equivalent experience
• Minimum 1 year of credentialing experience

Preferred:

• Bachelor’s degree

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Occasionally lift and/or move up to 20-25 pounds
• Fine hand manipulation (keyboarding)
• Frequently required to stand, walk, sit, use hands to feel, and reach with hands and arms
• While performing the duties of this job, the employee is regularly required to talk and hear
• Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to: remaining seated for periods of time to perform computer based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.)
• Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Office environment
• The noise level in the work environment is usually low

TRAVEL

• May visit hospital locations

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

The company is committed to creating a diverse, inclusive, and equitable environment and is proud to be an equal opportunity employer. Qualified applicants of any age, race, religion, nationality, sexual orientation, gender identity or expression, disability, or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds, experiences, and abilities and believe that the unique experiences of our team drive our success.

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