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Credentialing Coordinator

2 months ago

Ventura, California, United States Ventura Full time
Job Summary

We are seeking a highly skilled Credentialing Coordinator to join our team at Ventura County Medical Center. As a key member of our Medical Staff Services department, you will be responsible for coordinating all aspects of the privileging and credentialing process of licensed independent practitioners (LIPs) in accordance with regulatory requirements.

Key Responsibilities
  • Maintain knowledge and compliance with TJC, NCQA, and CMS credentialing and privileging standards
  • Process initial and reappointment applications, checking for completeness and accuracy
  • Ensure all credentials files are current and complete, including primary source verification of confidential and sensitive practitioner information
  • Maintain credentialing database with current practitioner information
  • Audit files based on internal standards and regulatory requirements
  • Monitor and report application status and provide appropriate correspondence
  • Assist with development and maintenance of Medical Staff delineation of privilege forms
  • Coordinate and record assigned medical staff committee meetings
  • Protect all credentialing information and files with strict confidence and limited access
  • Participate in preparation for health plan annual audits and reports
  • Maintain professional working relationship with Medical Staff, organization departments, clinics, and outside facilities
Requirements
  • Current National Association of Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) or actively pursuing certification and certification obtained within two (2) years of eligibility to sit for the exam
  • Intermediate computer skills using Microsoft products and web-based queries
  • Previous hospital medical staff or managed care credentialing experience
  • Experience with credentialing database software
  • Familiarity with TJC, CMS, and/or NCQA
Working Conditions

This position is highly regulated and subject to surveys and/or audits. The successful candidate will be able to work in a fast-paced environment and meet multiple priorities and competing deadlines.

Benefits

As a County of Ventura employee, you will be eligible for a comprehensive benefits package, including health insurance, retirement plan, and paid time off.