Credentialing Coordinator

4 weeks ago


San Antonio, Texas, United States Aleron Full time
Credentialing Coordinator Job Description

Are you looking for a challenging role in the healthcare industry? We are seeking a skilled Credentialing Coordinator to join our team at Aleron. As a Credentialing Coordinator, you will be responsible for facilitating the management and coordination of the complex credentialing and privileging process of physicians, mid-level providers, research associates, professionals, and paraprofessional individuals across multiple facilities.

Key Responsibilities:
  • Under minimal supervision, the Credentialing Coordinator is responsible for timely facilitating the management and coordination of the complex credentialing and privileging process of physicians, mid-level providers, research associates, professionals, and paraprofessional individuals across multiple facilities.
  • The Credentialing Coordinator will also assist in initiating and facilitating the Provider Enrollment process for billing.
  • The Credentialing Coordinator initiates access for providers Epic and other software and ensures information is accurate and updated.
  • The Credentialing Coordinator will maintain and ensure compliance with all licensures and appointments with state and governmental agencies, as well as certifications and professional liability coverage for each provider.
  • The Credentialing Coordinator also tracks and ensures the completion of needed continuing medical education courses/workshops.
  • Due to the complexity, the Credentialing Coordinator must be a self-starter who can adapt, multi-task, and understand the intricate credentialing and enrollment needs depending on the provider's specialty.
  • Mentors and guides lower-level team members.
  • Guide the provider through the credentialing and re-credentialing process and ensure the documentation is completed for the client and all facilities where the provider delivers services.
  • Works with Providers to prepare and submit Medicare & Medicaid applications to the enrollment office.
  • Prepare all credentialing applications, develop and provide documentation not supplied by the Provider, and address any additional information or corrections requested.
  • Verify and track the proper credentialing and re-credentialing of physicians, professionals, and paraprofessional individuals within a client and all facilities where the Provider has privileges.
  • Receive credentialing application and enter data into the credentialing system.
  • Work with Providers to maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications for each Provider. Generate a monthly report of expiring credentials.
  • Ensure ongoing performance monitoring between credentialing cycles, generate performance review documentation, share with the department for completion, and notify external entities when a Provider has been suspended, if necessary.
  • Work with Departments to obtain proof of Professional Liability coverage.
  • Provide support and information needed for monthly credentialing committee meetings and report initial and reappointments to the committee.
  • Notify Providers and departments of credentialing status and final result, email notice to the department and provider, and ensure the credentialing system (currently MD Staff) is updated with the final credentialing result.
  • Ensure the client website accurately reflects the Provider's credentials once cleared.
  • Track and complete needed continuing medical education courses/workshops and provide documentation to outside entities according to requirements.
  • Conduct customer service tasks such as responding to Providers, applicants, administrators, and hospital inquiries and providing documents to physicians and office staff seeking copies.
  • Perform all other duties as assigned.

Requirements:
  • High School Diploma or GED
  • Minimum 3 years of administrative experience in hospital or clinical field.


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