Credentialing Coordinator
2 months ago
Job title
Credentialing Coordinator
#FPCN-CREDCOR-
Reports to
Director of Financial Operations
Program Summary
The Family Practice & Counseling Network (FPCN) provides comprehensive primary care, dental and behavioral health services. We stand behind the belief that all people are entitled to accessible, comprehensive, quality, and affordable health care, and that care must be delivered in a culturally competent, trauma-informed and compassionate manner by caring for the whole person – mind, body & spirit. The network’s mission is to provide person-centered, integrated and comprehensive health services to individuals and families across their lifespan. The network promotes resiliency and well-being among patients, staff and surrounding communities.
We are a network of 3 comprehensive health centers, one convenient care center and six school-based health centers in Philadelphia.
Today, FPCN serves more than 15, patients annually and is a NCQA certified Patient-Centered Medical Home and recognized by HRSA as a National Quality Leader for Behavioral Health.
FPCN is opening Philadelphia’s First Birth Center ; its collaborating hospital is the University of Pennsylvania Hospital. This brand new 30, sq ft space will feature exam rooms, birthing suites, community meeting rooms and a gorgeous community garden park. The Family Health and Birthing Center will provide full prenatal, birth, and postpartum care in Southwest Philadelphia. Services include education on nutrition, exercise, childbirth preparation, breastfeeding, infant, and self-care; and mental health and substance abuse therapy for those who need it. These services will be provided by interdisciplinary teams of professionals led by nurse midwives and doulas, including behavioral health specialists, addiction counselors, social workers, and registered nurses. Additional services will include transportation assistance; lactation counseling; prenatal and parenting education; legal services; and complementary mind/body services, such as yoga, massage, and meditation. All staff will have training in anti-racism, justice, diversity, and inclusion (A-JEDI), trauma-informed care, and sanctuary model practices.
Position Summary
The Credentialing Coordinator is responsible for all aspects of the privileging and credentialing process for all FPCN providers. The Coordinator will process applications, verify information, research application details, and assure processes are in accordance with NCQA standards and applicable laws. The Coordinator will provide consistent, accurate, and timely credentialing support, enhancing the Network’s ability to provide healthcare services. The Credentialing Coordinator will take responsibility and ownership of all credentialing and enrollment data, including the integrity and accuracy of the systems/software where it is.
Essential Duties and Functions
1. Perform accurate, timely and documented verification of the information provided by the provider and maintenance of the highly confidential credentialing related files.
2. Ensures that all provider credentialing tasks are completed for new hires, according to the current HR/Credentialing checklist.
3. Partner with HR to make the new hire experience a positive one.
4. Create and facilitate completion of clinician applications for payers.
5. Process credentialing and re-credentialing applications of licensed staff including non-billable supportive medical staff and billable medical providers
6. Maintains compliance with documentation standards for verification of employee credentialing requirements, including but not limited to licenses, certifications, registrations, permits, educational degrees, association memberships.
7. Tracks and maintains copies of current credentialing documents and performs primary verifications and ensures:
- State licenses, certificates, malpractice coverage, and other required credentialing documents in confidential provider files.
- Update CAQH database with quarterly attestations, updating credentialing documents as needed/required.
8. Enters providers’ credentials and privileging data into the credentialing database.
9. Tracks and maintains Medicare exclusion checks for entire staff.
10. Coordinates and facilitates monthly Credentialing and Enrollment reporting to all applicable departments.
11. Manages any outsourced Credentialing and Enrollment vendors.
12. Manages software/systems selected for credentialing and enrollment. Assists in the selection of software/systems when needed.
13. Liaisons with Revenue Cycle Team on a regular basis to ensure reciprocal communication re: Credentialing.
14. Other responsibilities as assigned.
Qualifications
Certified Professional Credentialing Coordinator (CPCS Certified Provider Credentialing Coordinator (CPCS) or Certified Medical Staff Coordinator (CMCS) by the National Association of Medical Staff Services (NAMSS) preferred. Proficient in Microsoft Excel, Outlook, Word, and other credentialing/enrollment applications. Associates degree or equivalent experience RequirementsLifting Requirements
Light: exerting up to 20 pounds of force frequently, and/or negligible amount of force constantly to move objects. The use of arm and/or leg control requires force greater than sedentary, but worker still sits majority of time.Physical Requirement
Stand or Sit (stationary position) Walk Use hands or fingers to handle or feel (operate, activate, prepare, inspect, position) Climb (stairs/ladders) Talk/Hear (communicate, converse, convey, express/exchange information) See (detect, identify, recognize, inspect, assess) Pushing or Pulling Repetitive Motion Reaching (high or low) Kneel, Stoop, Crouch or Crawl (position self, move)Resources for Human Development is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, gender, gender identity, sexual orientation, national origin, genetic information, veteran, or disability status.
Visa Sponsorship : FPCN does not provide H1B Visa Sponsorship. All candidates must be US Citizens and/or authorized to work in the United States without Sponsorship.
Anti-Racist Justice, Equity, Diversity, and Inclusion (AJEDI) : FPCN is committed to providing an environment that does not discriminate or disproportionately impact underrepresented and under-resourced communities within the FPCN network. The network’s AJEDI initiatives strive to make FPCN a more equitable and just organization by helping to foster a culturally competent, inclusive, and integrated workplace.
Covid-19 Vaccine Mandate : FPCN, a program in the City of Philadelphia, are required to follow the COVID vaccine mandate for healthcare workers per Philadelphia Department of Public Health. FPCN requires Healthcare Workers to be fully vaccinated. Fully vaccinated means it has been two weeks since the final dose of vaccine. Thus, we require vaccination prior to start for all new hires. This currently does not include boosters.
Salary Description $67,-$73,-
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