Coordinator, Credentialing

3 weeks ago

Brooklyn, United States The Brookdale Hospital Medical Center Full time

Overview:

Responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing process. Facilitates all aspects of credentialing, including appointment, reappointment, monitoring and privileging for medical staff and allied health practitioners. Ensures compliance with the accrediting and regulatory agencies (i.e., Joint Commission and NCQA) in regards to credentialing while developing and maintaining a working knowledge of the statutes and laws. Responsible for the accuracy and integrity of the credentialing and clinical privileging database system and for ensuring the timeliness of credentialing / re-credentialing verification. Works under the supervision of the Medical Staff Services Director. Duties include the gathering, verification and evaluation of confidential healthcare provider credentials, as well as contacting and following up with contracted network facilities to obtain documentation relevant to the credentialing process and data entry of all credentialing information provided by contracted facilities.

Responsibilities:
  • Broad base of understanding, integration and application of BUHMC Credentialing policies and procedures.
  • Accurate review of provider application or reappointment application packet for completeness and accuracy for the timely submission to the Credentialing Committee and subsequent venues for provider appointment to meet regulatory, insurance and organizational requirements.
  • Knowledge of and implementation of NCQA standards for participation and preparation of physician files for audits.
  • Collects, verifies and ascertains information needed for processing new applications, reappointments, temporary privileges, etc.
  • Accurate input of initial and ongoing data elements recorded in the credentialing software system.
  • Completion of Credentialing Checklist as operational control for internal credentialing processes.
  • Creates and maintains accurate logs for mail, new applications, re-appointments and system generated letters and tracks progress of same.
  • Responds to inquiries for physician verification in an accurate and timely manner.
  • Facilitation in the depth investigation and documentation required for remediation and management of "red flags issues for Credentialing Committee determination / appropriate follow through.
  • Collection of required documentation with respect to the Delineation of Privileges for new appointments to the Medical Staff.
  • Recognition of data verification triggers and conducts data validation as needed.
  • Facilitate enrollment, communications and reporting for the enrollment of providers with third party insurers.
  • Recognition of data verification triggers; conducting data validation data integrity efforts on as needed basis
  • Develop and distribute ad hoc report requests as requested.
  • Self-directed, Independent organization of work efforts with a high degree of accuracy.
  • Demonstrates ability to prioritize work and meet deadlines.
  • Participates in the Department's performance improvement activities.
  • Maintains patient/employee confidentiality in the management of information.
  • Perform other duties when necessary.


Qualifications:

Education:

  • College degree preferred or an equivalent of education plus relevant experience in a healthcare environment.

Experience:

  • Minimum three (3) years of related experience in a healthcare setting.
  • Cactus Credentialing System.

Knowledge and Skills:

  • Excellent interpersonal and communication skills required.
  • Ability to prioritize work in an environment with multiple interests.
  • Ability to work independently with minimal supervision.
  • Ability to handle complex and confidential information with discretion.
  • Competency using a variety of computer software.
  • Ability to fully utilize BHMC's electronic record systems, equipment and healthcare and billing systems relevant to this position.

Licenses, Certifications:

  • Certified Provider Credentialing Specialist - CPCS preferred.

Physical Requirements:

  • Position requires prolonged periods of sitting and use of a computer and screen viewing throughout the working day.

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

The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of The Brookdale Hospital Medical Center.

BHMC is an equal opportunity employer, it is our policy to provide equal opportunity to all employees and applicants for employment without regard to race, color, religion, national origin, marital status, military status, age, gender, sexual orientation, disability or handicap or other characteristics protected by applicable federal, state, or local laws.

  • HR Generalist with Provider Credentialing Experience

    3 weeks ago

    Brooklyn, United States Doral Health & Wellness Full time

    **About Us**: Doral Health and Wellness is a leading healthcare organization dedicated to providing comprehensive and compassionate care to our patients. We are committed to promoting wellness and enhancing the quality of life for individuals and families in the Doral community. As we continue to grow and expand our services, we seek a talented individual to...

  • Emergency Credentialed Veterinary Technician

    2 weeks ago

    Brooklyn, United States Veterinary Emergency Group Full time

    WHO WE ARE Veterinary Emergency Group (VEG) is a rapidly growing emergency company with hospital locations across the United States. Our mission is helping people and their pets when they need it most. We are revolutionizing emergency medicine with a customer first mentality and a true, employee-centric work environment. TALENT + CULTURE AT VEG At VEG, we...

  • Billing Coordinator

    4 weeks ago

    Brooklyn, United States Heartshare Human Services Of New York Full time

    The Billing Coordinator is a detail-oriented and organized individual. The Billing Coordinator will be responsible for various billing tracking and follow with our Revenue Cycle Management Company (Millin) and ensuring compliance with audits and surveys. The Billing Coordinator will play a crucial role in supporting the financial operations of our...

  • Managed Care Coordinator

    2 weeks ago

    Brooklyn, United States PRIDE Health Full time

    Job Title: Managed Care CoordinatorLocation: 11212, Brooklyn NYContract Duration: 3-months (High possibility of extension)Hours per week: 40 (Full time)Job Description:We are currently seeking Managed Care Coordinators to facilitate communications for Nursing and Rehabilitation, insurance companies, and patients/residents. The primary responsibilities of...

  • Care Coordinator

    3 weeks ago

    Brooklyn, United States Bedford Stuyvesant Restoration Full time

    Bedford-Stuyvesant Restoration Corporation, founded in 1967, is the nation’s first community development corporation nestled in the heart of Central Brooklyn in Bed-Stuy. Located at Restoration Plaza, a 300,000 square foot commercial complex that offers a mix of retail, dining, recreation and entertainment, this historic organization is steeped in its...

  • Managed Care Coordinator

    2 weeks ago

    Brooklyn, United States Pride Health Full time

    Job Title: Managed Care CoordinatorLocation: 11212, Brooklyn NYContract Duration: 3-months (High possibility of extension)Hours per week: 40 (Full time)Job Description:We are currently seeking Managed Care Coordinators to facilitate communications for Nursing and Rehabilitation, insurance companies, and patients/residents. The primary responsibilities of...

  • Care Coordinator

    4 weeks ago

    Brooklyn, United States Good Shepherd Services Full time

    About Us Good Shepherd Services is a leading multi-service agency with more than 85 programs that serve over 30,000 youth and families each year - and builds on their strengths to help them gain skills for success. At Good Shepherd we respect the dignity and worth of every person and reject intolerance, inequity and injustice in whatever form it may take....

  • Care Coordinator

    4 weeks ago

    Brooklyn, United States Good Shepherd Services Full time

    About Us: Good Shepherd Services is a leading multi-service agency with more than 85 programs that serve over 30,000 youth and families each year and builds on their strengths to help them gain skills for success. At Good Shepherd we respect the dignity and worth of every person and reject intolerance, inequity and injustice in whatever form it may take....

  • Care Coordinator

    3 weeks ago

    Brooklyn, United States Good Shepherd Services Full time

    About Us Good Shepherd Services is a leading multi-service agency with more than 85 programs that serve over 30,000 youth and families each year - and builds on their strengths to help them gain skills for success. At Good Shepherd we respect the dignity and worth of every person and reject intolerance, inequity and injustice in whatever form it may take....

  • Veterinary Purchasing Coordinator

    3 weeks ago

    Brooklyn, United States BluePearl Vet, LLC Full time

    **BluePearl Pet Hospital** is **now **hiring for** an energetic, passionate, and driven Purchasing **Coordinator** to join our team.** **Pay**: $29.22 - $38.69 / hour **This pay band is a starting point and is dependent on experience.** The Purchasing Coordinator supports the Commercial function by evaluating and approving vendors, authorizing purchase...

  • Education/disabilities Coordinator

    2 weeks ago

    Brooklyn, United States Grand St Settlement Inc. Full time

    TITLE: Early Head Start-Child Care (EHS-CC) Education & Disabilities Coordinator DEPARTMENT: Early Childhood Services LOCATION(S): Brooklyn REPORTS TO: EHS- CCP Program Manager SALARY RANGE: $85,000 DATE: April 2024 SCHEDULE: Monday-Friday, 8 am-4 pm, or 9 am-5 pm. Schedule may vary due to program needs JOB SUMMARY: The Education and Disabilities...

  • Veterinary Financial Coordinator

    2 weeks ago

    Brooklyn, United States BluePearl Vet, LLC Full time

    BluePearl Pet Hospital is seeking an organized, fiscally responsible, and goal-driven **Financial Coordinator **to join our team located in **Brooklyn, NY.** As the Financial Coordinator, you will have primary responsibility for charge capture and other billing-related activities across the hospital. You will ensure that all charges are captured properly by...

  • HR Business Operations Coordinator

    1 month ago

    BROOKLYN, United States Graham Windham Full time

    HR Business Operations Coordinator Job Details Level Entry Job Location 1 PIERREPONT PLAZA SUITE 901 - BROOKLYN, NY Position Type Full Time Education Level High School Salary Range $25.22 Hourly Job Category Human Resources Description Human Resources Business Operations Coordinator About Graham Windham In full...

  • HR Business Operations Coordinator

    4 weeks ago

    BROOKLYN, United States Graham Windham Full time

    HR Business Operations Coordinator Job Details Level Entry Job Location 1 PIERREPONT PLAZA SUITE 901 - BROOKLYN, NY Position Type Full Time Education Level High School Salary Range $25.22 Hourly Job Category Human Resources Description Human Resources Business Operations Coordinator About Graham Windham In full...

  • Veterinary Purchasing Coordinator

    4 weeks ago

    Brooklyn, United States BluePearl Full time

    **BluePearl Pet Hospital** **is** **now** **hiring for** **an energetic, passionate, and driven Purchasing** **Coordinator** **to join our team.** **Pay:** $29.22 - $38.69 / hour **This pay band is a starting point and is dependent on experience.** The Purchasing Coordinator supports the Commercial function by evaluating and approving vendors, authorizing...

  • Veterinary Financial Coordinator

    2 weeks ago

    Brooklyn, United States BluePearl Full time

    BluePearl Pet Hospital is seeking an organized, fiscally responsible, and goal-driven Financial Coordinator to join our team located in Brooklyn, NY. As the Financial Coordinator , you will ha ve primary responsibility for charge capture and other billing-related activities across the hospital. You will ensure that all charges are captured properly by...

  • International Student Program/ESL Support Coordinator

    4 weeks ago

    Brooklyn, New York, United States BASIS Independent Brooklyn Upper Full time

    BASIS Independent Brooklyn Upper is seeking qualified candidates for an International Student Program/ESL Support Coordinator What We're Looking For: As International Student Program Coordinator/ESL Support, your first responsibility will be to support our international students in Grades 6 -12 with English as a Second Language acquisition. You will...

  • International Student Program/ESL Support Coordinator

    2 months ago

    Brooklyn, New York, United States BASIS Independent Brooklyn Upper Full time

    BASIS Independent Brooklyn Upper is seeking qualified candidates for an International Student Program/ESL Support Coordinator What We're Looking For: As International Student Program Coordinator/ESL Support, your first responsibility will be to support our international students in Grades 6 -12 with English as a Second Language acquisition. You will...

  • Sonography Clinical Coordinator. Job in Brooklyn Allied-IT Jobs

    1 month ago

    Brooklyn, New York, United States Touro University Nevada Full time

    Overview The Clinical Coordinator will serve the Sonography Program at Machon L'Parnasa in all clinical education capacities, as well as provide scan lab and didactic instruction. ResponsibilitiesCorrelate and coordinate clinical education and evaluate its effectiveness. Evaluate the progress of student performance in the clinical area. Work with the Program...

  • Sonography Clinical Coordinator. Job in Brooklyn Allied-IT Jobs

    4 weeks ago

    Brooklyn, United States Touro University Nevada Full time

    Overview The Clinical Coordinator will serve the Sonography Program at Machon L'Parnasa in all clinical education capacities, as well as provide scan lab and didactic instruction. Responsibilities Correlate and coordinate clinical education and evaluate its effectiveness. Evaluate the progress of student performance in the clinical area. Work with the...