Credentialing Coordinator

Remote in FL, OH, NVJoin our team at Cleveland Clinic and experience world-class healthcare at its best. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will be part of a talented, compassionate, and driven team of caregivers. You will work with state-of-the-art technology and provide stellar patient care. At Cleveland Clinic you will build a rewarding career with one of the most respected healthcare organizations in the world. The Credentialing Coordinator will coordinate all aspects of credentialing and verification. You will coordinate the development and maintenance of systems and procedures within the Credentialing Office to ensure timely, thorough and accurate credentials verification. You will also ensure CCF's compliance with State, National, JCAHO, NCQA and URAC credentialing requirements. The coordinator develops and maintains effective lines of communication necessary for CCF's credentialing operations.The ideal caregiver is someone who: Has credentialing experience. Is quick in processing files and reappointment files. Has organizational and multitasking skills. Has High-level management and leadership skills. Can schedule and manage tasks effectively.At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.Responsibilities:Coordinates the development and maintenance of systems and procedures within the Credentialing Office to ensure timely, thorough and accurate credentials verification.Coordinates appointment and reappointment process for all CCF- professional staff, medical staff and Advanced Practice Providers.Meets credentialing/re-credentialing deadlines.Maintains and tracks professional license renewals.Coordinates and processes all application for reappointment on a timely manner as required by TJC and NCQA.Reviews and processes all request for temporary and on-case privileges to physicians.Assists in maintaining peer review files for all physician and advanced practice providers credentialing files in an organized and consistent manner.Assists with all components of the preliminary primary source verification process.Develops and maintains effective lines of communication necessary for CCF's day to day credentialing operations.Ensures CCF's compliance with State, National, TJC, NCQA and URAC credentialing requirements.Obtains credentialing information on all new CCF medical staff members. Informs OPSA, Department/Division Chairs and Legal of highly sensitive, sometimes adverse, information uncovered in the credentialing/re-credentialing process.Adheres to credentialing timeframes and deadlines dictated by regulatory bodies so that provider files stay in compliance at all times.Assists Manager in file review for annual audits by Manage Care Plans.Develops and implements ways in which to improve and more efficiently accomplish compliance per NCQA per the delegated plans.Assists with the departmental orientation of new Medical Staff Members, including maintaining and updating Physician Orientations packets.Prepares and emails all application for privileges and follow-up phone calls to doctor offices to expedite credentialing.Performs all Quarterly License and monthly OIG/Medicare Sanctions and EPLS required checks.Maintains Physician Acknowledgment Statements to meet FMQAI requirements.Tracks and maintains all License, DEA, Malpractice Insurance, and Board Certification expiration dates.Updates revised and current delineation of privilege forms for physicianAssists with Annual Staff Meeting preparation.Distributes, collects, and tabulates all Medical Staff voting items.Maintains all demographic information on all Medical Staff Rosters.Maintains complete and up-to-date documentation and filesProvides positive welcome to all medical staff members.Assists Manager in development and fulfillment of short/long term departmental goals.Other duties as assigned.Education: High School Diploma or GEDLanguages:N/ACertifications:Certified Professional Credentialing Specialist (CPCS) and/or Certified Professional Medical Services Management (CPMSM) certification preferred or willingness to obtain plexity of Work:All employees are expected to meet the standards of performance outlined in the Organizational-Wide Competencies listed below as applied to the position:World Class Service Orientation: Includes attitude, behavior, interpersonal skill, and problem solving that enable an employee to respond to internal and external customer needs and expectations in a positive manner.Adaptability: Includes teamwork and flexibility needed to fulfill job responsibilities including adapting to changes in work environment and accepting supervisory feedback.Efficiency and Effectiveness: Includes quantity and quality of desired work, as well as organization skills necessary to perform successfully.Essential Job Requirements: Includes adherence to all relevant policies, procedures, and guidelines affecting the work environment, including maintenance of required competencies and communication skills.Supervisory Responsibilities (if applicable): Includes overall accountability for assigned work group relative to operational goals, personnel requirements, and budgetary constraints.Note: The above stated duties are intended to outline those functions typically performed by individuals assigned to this classification. This description of duties is not intended to be all inclusive or to limit the discretionary authority of supervisors to assign other tasks of similar nature or level of responsibility.This position requires knowledge of all aspects of Medical Staff Services work.Effective skills in communication.Ability to assume responsibility.Verbal and written communication skills to communicate with staff, physicians, peers, superiors, vendors, patients, and their families.Numerical ability is required.Able to handle multiple tasks using time management principles to meet goals and deadlines.Ability to retrieve, communicate and present data and information is essential.The ability to maintain confidentiality of information is essential.Advanced knowledge of credentialing functions and systems, normally gained through direct experience in a credentialing office or related setting.Excellent communication/interpersonal skills necessary to interface with all levels of CCF manager, employees and Professional Staff.Working knowledge of licensure requirements in the State of FloridaThrough knowledge of current credentialing standards of TJC, NCQA, URAC and reporting criteria for the National Practitioner Data puter literate with working knowledge of database maintenanceAbility to effectively problem solves and troubleshoots.Work Experience: Minimum of three years of experience coordinating and developing office systems and procedures to include two years in a medical staff office performing credentialing functions.Physical Requirements:Ability to perform work in a stationary position for extended periodsAbility to operate a computer and other office and laboratory equipmentAbility to travel throughout the hospital systemAbility to communicate and exchange accurate information.Personal Protective Equipment:Follows standard precautions using personal protective equipment.Pay RangeMinimum hourly: $17.25Maximum hourly: $26.31The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic's benefits package, which includes among other benefits, healthcare/dental/vision and retirement.