Credentialing and Privileging Coordinator

4 weeks ago


Austin, Texas, United States CommUnityCare Full time
Job Summary

We are seeking a highly skilled Credentialing and Privileging Coordinator to join our team at CommUnityCare. As a key member of our medical staff services team, you will be responsible for ensuring the credentialing and privileging process for our healthcare providers is accurate, efficient, and compliant with regulatory requirements.

Key Responsibilities
  • Facilitate the initial credentialing, re-credentialing, and privileging process for healthcare providers
  • Apply the credentials evaluation process uniformly to all initial, re-credentialing, and additional privilege applications
  • Process each initial, re-credentialing application received in accordance with Credentialing and Privileging Policy/Process
  • Compile and analyze internal data and information for an assessment of qualifications and competencies for each re-credentialing application
  • Facilitate review, assessment, and authenticated documentation for an evaluation of each application and request for clinical privileges by the Medical Director
  • Facilitate review, assessment, and recommendations for each application and request for clinical privileges by the Medical Director and the Credentials Committee
  • Summarize and prepare credentialing information, including flagged concerns, for the Credentials Committee and boards review and decisions
  • Actively manage providers expiring credentials in accordance with Credentialing and Privileging Policy/Process
  • Update the Access system to reflect all board actions on a providers initial, re-credentialing, and additional privilege requests
  • Manage and archive files according to Credentialing and Privileging Policy and Process
Requirements
  • Minimum 3 years experience in a credentialing and privileging role with knowledge of ambulatory, managed care, and hospital initial and re-credentialing processes
  • Strong knowledge of NCQA, JC, HRSA, URAC, CMS, and TDI guidelines
  • PREFERRED: Bachelors Degree in Business Administration, Healthcare Administration, or related field
  • PREFERRED: Certified Professional Credentialing Specialist (CPCS) or in process of certification
What We Offer

As a Credentialing and Privileging Coordinator at CommUnityCare, you will have the opportunity to work in a dynamic and fast-paced environment with a team of dedicated professionals. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.

We are an equal opportunity employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.



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