Coordinator, Delegated Credentialing

St. Luke's University Health Network•Bethlehem, PA

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Coordinator, Delegated Credentialing is responsible for the verification of information submitted by a Physician or an Advanced Practitioner applying for Medical Staff privileges at St. Luke’s University Health Network facilities. Ensures that compiled data is in in compliance with all regulatory and accrediting requirements, including insurance payers. Ensures that all information for Medical Staff appointment is complete and accurate.

Requirements

High School diploma or equivalent required.
Experience with personal computers and Microsoft Office is required.
Strong customer service skills.
Excellent verbal and written communication skills.
Detail and service oriented.

Responsibilities

Fields requests from providers to become members of SLCN and assures submitted documents are complete
In preparation for CVO Credentialing Committee meeting, confirms completion of provider verifications and other documents
Prepares credential and recredential files for delegated credential payer audits.
Coordinates audit, communicates with payer representatives, assures remediation as needed
Performs activities related to the Network credential verification process for initial, temporary and reappointment applications for Physicians and Advanced Practitioners
Verifies credentials of providers are in compliance with regulatory and accrediting requirements
Collaborates with Medical Staff and leadership to ensure credentialing and processing standards are met.
Reaches out to Medical Staff as necessary for timely completion of credentialing information
Conducts data analysis of assigned credentials files and documents ensuring an accurate and current practitioner database utilizing the Credentialing software
Ensures accurate and timely verification of provider credentials and privileges according to established policies and procedures
Posts accurate credentialing information on the Physician Web as documentation is completed for APS and Credentialing Committees approval