Credentialing Coordinator

2 days ago

Chicago, United States Sinai Chicago Full time

About Us:

At Sinai Chicago, we take health care personally. Excellence in health care is about more than just medicine, technology, tests and treatments, it is about really caring for people with dignity and respect. Thats what we do. We are dedicated to providing the best care to meet the needs of people, for our community, for our patients and for you.

Position Purpose:

The Credentialing Coordinator is responsible for all aspects of credentialing and re-credentialing of health care professionals. This position ensures all health care professionals are appropriately credentialed, which includes the responsibility of maintaining current information on file and within the credentialing database. This position primarily works independently, but frequently coordinates with other team members, Credentialing Manager and Medical Director.

Key Job Activities:

  • Collection and completion of health care professionals credentialing and re[1]credentialing applications. Responsible for monitoring and managing credentialing/re-credentialing requirements and to ensure the collection of all required renewal certifications are on file within the required time frame.
  • Provides consistent and timely follow-up on all outstanding credentialing/re[1]credentialing application.
  • Maintains and monitors dedicated credentialing email box daily and provides support to physicians, physician office staff, health plan contacts and company departments as necessary.
  • Processes provider demographic changes ensuring appropriate documentation has been submitted with the changes update credentialing database and notify health plans of changes.
  • Submits monthly requests to all health plans for provider credentialing status. Assures database is updated and any documentation has been saved to the appropriate folder.
  • Assures all providers and sites are listed in all Payer Directories.
  • Submits updates and corrections to the online directories to health plans timely.
  • Maintains database expiration and renewal dates, i.e. licenses, malpractice and board certifications.
  • Scans and files documents to the credentialing files.
  • Cross-covers for all credentialing department caregivers as appropriate.
  • Performs other duties as assigned.
  • Submits new providers to Medicare and Medicaid for enrollment.
  • Submits provider terminations to Health Plans monthly, providing information for membership moves for terminating PCPs to health Plan to assure membership is maintained by ProgressHealth PHO.

Education and Work Experience:

  • High school diploma or equivalency, associate degree preferred
  • Highly proficient with the use of computers Word, Excel, and Access
  • Three years of experience with multi-specialty Physician groups is highly preferred

Certifications/Licenses:

  • CMSC is preferred

Workplace Conditions:

PHYSICAL DEMANDS:

  • While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle or feel; and talk or hear
  • The employee frequently is required to walk and stoop, kneel, crouch
  • The employee is occasionally required to stand
  • The employee must occasionally lift and/or move up to 25 pounds.
  • Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus

WORK ENVIRONMENT:

  • General office environment and the noise level in the work environment is usually moderate

BLOOD-BORNE PATHOGEN EXPOSURE CATEGORY:

Category 1 - Job usually involves contact with patients or patients specimens. Exposure to blood, body fluids, non-intact skin or tissue specimens, is possible

Category 2 - Job may expose incumbent occasionally or in emergency situations to blood, body fluids, non-intact skin or tissue specimens

x Category 3 - Job does not involve exposure to blood, body fluids, non-intact skin or tissue specimens. Incumbent does not perform or help in emergency medical care or first aid as a part of his/her job.

Benefits:

Sinai Health Systems goal is to provide you with the most comprehensive benefit package possible while balancing our fiscal commitments and obligations. Sinai Health Systems currently offers its employees the option to participate in a full range of benefits, including a health care program which includes medical, dental, vision and prescription coverage. Along with Employer Paid Life and Accidental Death & Dismemberment (AD&D), Supplemental Life, Short-Term and Long-Term Disability, Health Savings Account (HSA) and Flexible Spending Account (FSA), Employee Assistance Program and Student Loan Assistance. Participation in some programs requires that employees be regularly scheduled to work a minimum number of hours and/or to have fulfilled a waiting period after they begin employment with Sinai Health Systems.

Registry (per diem) Caregivers are caregivers who work less than 1,000 hours in a calendar year. Registry caregivers are employees of Sinai Health System but are typically on an as needed basis. These caregivers may be called upon to cover full-time or part-time caregivers during PTO events or sick leave as well as to provide supplemental coverage. Registry Caregivers are not eligible for Sinais benefit programs with the exception for Sick-C, PPO Medical Plan, Employee Assistance Program (EAP) and non-match eligible contribution to the Sinai Health System Consolidated 403(b) retirement savings plan.

Living the Values:

  • TEAMWORK - Caregiver works together with other caregivers to create and maintain an inclusive workplace where differences, inclusivity, conflict resolution and open communication are valued
  • RESPECT - Caregiver shows mutual respect and fairness, treats each person with dignity and encourages each individuals unique talents and contributions
  • QUALITY - Caregiver improves our services by following protocol and suggesting improvements based on observations, continuous learning and industry best practices
  • INTEGRITY - Caregiver holds self and others accountable for their actions and are honest and ethical in all dealings
  • SAFETY - Caregiver practices behaviors that promote safety for all patients, visitors, and caregivers
  • ROLE MODEL - Caregiver is a dependable role model and champions our values through their daily interactions with patients, customers and coworkers

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