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Provider Credentialing Coordinator
2 months ago
Position Summary:
This role is dedicated to the establishment, oversight, and maintenance of provider credentialing with various employer groups, managed care organizations, insurance entities, medical staff offices, and healthcare professionals.
Key Responsibilities:
- Adheres to and promotes the mission, values, objectives, policies, and ethical standards of Community Health Systems, Inc.
- Safeguards the organization's integrity by ensuring confidentiality of sensitive information.
- Facilitates and completes the credentialing process for both new and existing healthcare providers.
- Regularly monitors, updates, and informs supervisors regarding provider and clinic licenses to maintain current status.
- Conducts preliminary data queries on provider applicants prior to employment.
- Comprehends and executes the necessary procedures to comply with laws and regulations related to provider credentialing and clinic licensing.
- Electronically queries the National Practitioner Data Bank for initial appointments, reappointments, changes in privileges, and temporary privileges for each clinic.
- Processes all initial applications for medical and allied health professional staff appointments and clinical privileges in accordance with clinic operational policies and procedures.
- Maintains an up-to-date database of licensed and certified providers, including medical licenses, DEA certificates, malpractice insurance, and renewal deadlines.
- Continuously communicates with Medical and Dental Directors, providing monthly expiration reports and rosters upon request.
- Keeps organized credential files and assists with inspections by regulatory bodies or accreditation surveyors, ensuring compliance with federal and state guidelines during application processing.
- Ensures timely processing of all privilege requests.
- Maintains current credentialing files in compliance with relevant standards.
- Responds to inquiries from providers received through various communication channels.
Additional Duties:
Performs any other tasks as assigned, whether formally or informally, verbally or in writing.
Community Health Systems, Inc. (CHSI) operates as a Federally Qualified Health Center (FQHC) and is a Non-Profit 501 (C)(3) organization, managing multiple community health centers across various regions.
CHSI is committed to delivering high-quality and compassionate healthcare services, including medical, dental, women's health, behavioral health, and vision care, to underserved, uninsured, or under-insured populations.
As a non-profit entity with HRSA Grantee status and FQHC designation, CHSI has expanded from its origins in Bloomington Community Health Center, growing to serve communities in several counties.
These health centers adhere to standards set for safety net providers by the U.S. Department of Health and Human Services (HHS), the Health Resources Services Administration (HRSA), the Public Health Service (PHS), and the Bureau of Primary Health Care (BPHC).
The mission of CHSI is to serve the indigent population and address their healthcare needs without competing with other clinics providing similar services.
