Credentialing Coordinator
4 weeks ago
The Credentialing Coordinator is responsible for assuring that the credentialing of practitioners is conducted in accordance with the Office of Integrated Credentialing/client policies and procedures, entity bylaws/credentialing plan, regulatory agencies, and accrediting bodies. The Credentialing Coordinator performs quality control audits and coordinates the preparation of completed practitioner files, maintains accurate records regarding the processing status of each practitioner, and flags potentially adverse information. The Credentialing Coordinator is responsible for assuring all activities are conducted as scheduled and per departmental standards.
**Essential Duties**:
- Follow up with client Medical Staff Offices, Departments, clients, practitioners and other respondents regarding incomplete/missing information on documents received according to OIC procedures.
- Maintains paper/electronic credentials files, clinical privilege forms (as assigned) and practitioner databases to insure information contained is accurate and current. Effectively utilizes all software systems to perform essential job functions, adhering to established data entry conventions.
- Perform electronic, written and telephonic queries to agencies providing primary source information regarding malpractice claims, licenses, certifications, training and affiliations. Assess content of responses to determine any follow up required.
- Monitor receipt of credentialing information and insure that second and third requests are sent within the defined time frame.
- Evaluate the completeness and integrity of initial applicant, reappointment applicant, and annual evaluation files, and determine when all necessary verificatons and required documents have been completed and are present for appropriate chair/chief/designee and committee review.
- Work closely with the supervisor in identification of reappointment names and dates
- Independently make decisions regarding whether information meets OIC, TJC, NCQA, DNV, Title 22, and CMS and relevant bylaws/Credentialing Plan requirements related to content, completeness and timeliness.
- Ensures maximum confidentiality, accuracy, security, and appropriate access of all data and records, and provides maximum protection from discoverability of all information.
- Prepare completed, accurate practitioner credentials files for delivery to clients.
- Participates in facility/credentialing preparation for site visits and licensing/accreditation surveys
- Participate in preparation for and support of internal and external audits of OIC processed files
- EXPIRABLES MANAGEMENT, as required. Responsible for managing the expiring documents process prior to updating the provider database. Verifies current license, malpractice insurance, DEA, board certification, and other applicable certifications, as required. Contact practitioner prior to expiration of doucments, notified department coordinator/administrator and/or facilities of pending expiriations Process includes accurate data entry and image scanning. Sends notifications of provider expired credentials to OIC supervisor, medical staff clients, hospital departments, provider’s department coordinatore, provider’s chair/chief
- ONGOING MONITORING, as required Reviews all applicable State Licensing Board Reports (all boards for which we have credentialed providers) monthly to determine whether any unfavorable actions were taken, including but not limited to Medical Board of CA, Osteopathic Medical Board, Dental Board of CA, Board of Registered Nursing, Board of Pharmacy, Clinical Psychology, Physical Therapy Board, Occupational Therapy Board, etc. Notifies supervisor of any Red Flag reports identified. Prints hard copies of Red Flag Information. Maintains electronic and/or paper copies of State Licensing Board Reports each month for future review and reference. Reviews OIG, EPLS and Palmetto reports on a monthly basis and maintains copies of the reports for future review and reference. Notifies supervisor of any Red Flag reports.
- OTHER, as required Answer all incoming calls in a timely manner, provides courteous and professional phone support Office Maintenance - Orders and maintains office supplies; coordinates care and maintenance of departmental space and equipment. Stores old files, scans, and destroys confidential documents according to departmental policies. Provides and maintains a file system that allows for easy retrieval of information. Works collaboratively in dissemination of provider data across the enterprise and externally as needed, including, but not limited to: IT, Quality & Outcomes, Compliance, Pharmacy, Call Center, HIM etc. Meeting Scheduling - Coordinates meeting dates and times with all participants. Arranges for conference rooms or other meeting locations, audio-visual equipment, or catering services as needed.
- Completion of User Provisioning forms that are forwarded to IT for USC Care approved initial applicants, as applic
-
Credentialing Coordinator
3 days ago
Los Angeles, United States Regal Medical Group Full timeJob Description Position Summary: Credential all new providers, Re-credential existing Providers according to Regal Medical Group credentialing policies and procedures. Submit credentialing information as requested by contracted HMOs. Maintain and update files on all credentialed Providers. Provide credentialing information on a Provider when requested by...
-
Credentialing Coordinator
4 weeks ago
Los Angeles, CA - Health Sciences Campus, United States Keck Medicine of USC Full timeThe Credentialing Coordinator is responsible for assuring that the credentialing of practitioners is conducted in accordance with the Office of Integrated Credentialing/client policies and procedures, entity bylaws/credentialing plan, regulatory agencies, and accrediting bodies. The Credentialing Coordinator performs quality control audits and coordinates...
-
Credentialing Coordinator
4 weeks ago
Los Angeles, CA - Health Sciences Campus, United States Keck Medicine of USC Full timeThe Credentialing Coordinator is responsible for assuring that the credentialing of practitioners is conducted in accordance with the Office of Integrated Credentialing/client policies and procedures, entity bylaws/credentialing plan, regulatory agencies, and accrediting bodies. The Credentialing Coordinator performs quality control audits and coordinates...
-
Credentials Coordinator II
2 weeks ago
Los Angeles, United States Cedars-Sinai Full timeGrow your career at Cedars-Sinai! Cedars-Sinai Medical Center has been ranked the #1 hospital in California by . News & World Report, 2023‑2024. Beyond an outstanding benefit package and competitive salaries. We take pride in hiring the best, most passionate employees. Our talented doctors, nurses and staff reflect the culturally and ethnically...
-
Human Resource Coordinator
4 days ago
Los Angeles, United States Rios Inc Full timeDescription: RIOS is seeking a full-time Human Resource Coordinator to support our Human Resource team. The Human Resource Coordinator assists with and facilitates a variety HR processes. This role aids the administration of employee health and welfare plans and acts as liaison between employees and insurance providers. This position resolves...
-
Business Development Coordinator
5 days ago
Los Angeles, United States Zambezi Full timeWe are looking for a Business Development Coordinator to join our Growth team. You’re a budding entrepreneur at heart, a serial researcher, and a proactive team player who is not afraid to voice an opinion. You pride yourself on your writing skills and you embrace any chance to flaunt them. You’re 50% organizational ninja, 50% proactive project manager...
-
Protocol Coordinator
2 days ago
Los Angeles, California, United States University of Southern California (USC) Full timeThe University of Southern California (USC), founded in 1880, is the largest private employer in the City of Los Angeles. As an employee of USC, you will be a part of a world-class research university and a member of the "Trojan Family," which is comprised of the faculty, students and staff that make the university what it is. This position requires a person...
-
Client Finance Coordinator
2 days ago
Los Angeles, United States TTD Full timeJob Description Job Description Salary: DOE Position Title: Client Finance Coordinator Department: Billing Department Reports To: Owner/HR Director General Summary: The Client Finance Coordinator is responsible for handling collections and financial matters related to patients' responsibilities. This role involves managing inbound and outbound calls to...
-
Educational Coordinator
1 month ago
Los Angeles, United States Amity Foundation Full timeJob DescriptionJob Description Amity Foundation, internationally acclaimed teaching, and therapeutic community is seeking compassionate and enthusiastic individuals with a desire to teach, learn and join our community as an Educational Coordinator. This groundbreaking opportunity not only will allow you to work with our prison programs to help the inmate...
-
Client Finance Coordinator
3 weeks ago
Los Angeles, United States TTD Full timeJob DescriptionJob DescriptionSalary: DOEPosition Title: Client Finance CoordinatorDepartment: Billing DepartmentReports To: Owner/HR DirectorGeneral Summary: The Client Finance Coordinator is responsible for handling collections and financial matters related to patients' responsibilities. This role involves managing inbound and outbound calls to assist...
-
Client Finance Coordinator
3 weeks ago
Los Angeles, United States TTD Full timeJob DescriptionJob DescriptionSalary: DOEPosition Title: Client Finance CoordinatorDepartment: Billing DepartmentReports To: Owner/HR DirectorGeneral Summary: The Client Finance Coordinator is responsible for handling collections and financial matters related to patients' responsibilities. This role involves managing inbound and outbound calls to assist...
-
CCT Transition Coordinator
4 weeks ago
Los Angeles, United States Libertana Home Care Full timeJob DescriptionJob DescriptionPosition Summary:The CCT Coordinator is responsible for coordinating the options that are available to SNF residents. The CCT Coordinator is responsible for assisting in the liaison work between the State of California and the Community in which clients from local nursing facilities will reside. QUALIFICATIONSPreferably, has a...
-
Business Development Coordinator
3 days ago
Los Angeles, United States Zambezi Full timeWe are looking for a Business Development Coordinator to join our Growth team. You’re a budding entrepreneur at heart, a serial researcher, and a proactive team player who is not afraid to voice an opinion. You pride yourself on your writing skills and you embrace any chance to flaunt them. You’re 50% organizational ninja, 50% proactive project manager...
-
Business Development Coordinator
4 days ago
Los Angeles, United States Zambezi Full timeWe are looking for a Business Development Coordinator to join our Growth team. You’re a budding entrepreneur at heart, a serial researcher, and a proactive team player who is not afraid to voice an opinion. You pride yourself on your writing skills and you embrace any chance to flaunt them. You’re 50% organizational ninja, 50% proactive project manager...
-
Business Development Coordinator
3 days ago
Los Angeles, United States Zambezi Full timeWe are looking for a Business Development Coordinator to join our Growth team. You’re a budding entrepreneur at heart, a serial researcher, and a proactive team player who is not afraid to voice an opinion. You pride yourself on your writing skills and you embrace any chance to flaunt them. You’re 50% organizational ninja, 50% proactive project manager...
-
Special Event Food Coordinator
1 month ago
Los Angeles, United States DLS Events LLC Full timeEssential Functions and Responsibilities: - Advancing the food vendor needs for their event based on timeline provided - Collecting all needed documents from the food vendors; permits, insurance, tenting, power, credential, and menu needs - Communicating regulations and guidelines for each event, providing vendors with load in and out information -...
-
PNO Contract Coordinator
3 weeks ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) – Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team. This includes but is not limited to pre and post negotiation management,...
-
Coordinator, Touring
4 days ago
Los Angeles, United States Aeg Worldwide Inc Full timeFor more than 20 years, AEG has played a pivotal role in transforming sports and live entertainment. Annually, we host more than 160 million guests, promote more than 10,000 shows and present more than 22,000 events around the world. We are committed to innovation, artistry, and community, and leverage the power of our 300+ venues, leading sports franchises,...
-
Coordinator, Touring
3 hours ago
Los Angeles, United States Aeg Worldwide Inc Full timeFor more than 20 years, AEG has played a pivotal role in transforming sports and live entertainment. Annually, we host more than 160 million guests, promote more than 10,000 shows and present more than 22,000 events around the world. We are committed to innovation, artistry, and community, and leverage the power of our 300+ venues, leading sports franchises,...
-
Transportation Coordinator
1 week ago
Los Angeles, United States Nationwide Auto Services Inc Full timeDescriptionAs one of the largest OEM and OES servicers in the country, Nationwide Auto Services, Inc. provides a varied mix of services. Performed by the extensively trained members or the NAS team, we can customize our systems to assist you most effectively.NAS is committed to providing the highest level of CUSTOMER SATISFACTION by supporting an array of...
