Credentialing Coordinator (Int – Senior), Credentialing Specialist (Prin Prof)

University of Colorado•Aurora, CO

9d•$56,895 - $94,951•Onsite

About The Position

The Department of Radiology is seeking a highly organized and detail-oriented Credentialing Coordinator to join our growing team. This position is ideal for an individual who enjoys problem solving, managing multiple projects, and serving as a trusted resource for healthcare providers and practice administrators. The Credentialing Specialist is responsible for managing and maintaining the credentialing and re-credentialing process for Radiology healthcare providers, to ensure compliance with regulatory standards, accreditation requirements, and organizational policies. This role ensures that Radiology medical staff meet the qualifications and maintain active status with governing bodies while also developing and maintaining a working knowledge of relevant policies and procedures. The ideal candidate is outgoing, professional, organized, detail-oriented, and willing and able to learn new processes quickly and adapt to the ever-changing healthcare landscape. This role will serve as the face of the department and often, you will make the first impression for new faculty physicians and medical staff. In this role, you must be comfortable speaking to people you have never met before, including physicians, and able to exercise social grace during these important interactions. At the principal level, the Credentialing Specialist role will operate as the department’s subject matter expert related to the maintenance of the documentation for the verification processes used to confirm healthcare provider’s credentials and professional standing, accreditation requirements or organizational policies.

Requirements

A bachelor’s degree in business, business administration, finance, accounting, education, social sciences, healthcare administration, public administration, communications, information systems, or a directly related field from an accredited institution. Substitution: A combination of education and related technical/military/paraprofessional experience may be substituted for the bachelor’s degree on a year-for-year basis.
1 year of professional compliance experience which included regulatory standards, accreditation requirements, or organizational policies in an academic, healthcare, and/or business environment (Intermediate Professional).
2 years of professional compliance experience which included regulatory standards, accreditation requirements, or organizational policies in an academic, healthcare, and/or business environment (Senior Professional).
3 years of professional compliance experience which included regulatory standards, accreditation requirements, or organizational policies in an academic, healthcare, and/or business environment (Principal Professional).
Experience with healthcare provider credentialing.
Applicants must be legally authorized to work in the United States without requiring sponsorship.
Ability to communicate effectively, both in writing and orally.
Ability to establish and maintain effective working relationships with employees at all levels throughout the institution.
Outstanding customer service skills.
Ability to establish work priorities and follow-through to ensure completion of activities to best meet division business needs in an environment with many competing.
Ability to conceptualize, document and implement process improvements.
Significant knowledge and proficiency with Microsoft Excel, Word, Teams, PowerPoint and Outlook.
Ability to work independently as well as collaboratively to identify and set priorities for self and others.
Excellent analytical and problem-solving skills.
Demonstrated ability to think critically about data as it relates to systems, stakeholders, decision-making, and support of organizational strategy.
Ability to evaluate, analyze, and interpret vast amounts of data in order to recommend solutions and implement a preferred course of action.
Strong organizational skills with attention to detail.
Ability to maintain confidentiality and exercise appropriate discretion with information.
Ability to exercise sound judgment and meet deadlines in a fast-paced work environment.
Ability to envision innovative ways of doing things to assertively challenge the status quo.

Nice To Haves

Experience working in a healthcare or university setting.
Experience working with multiple credentialing units at one time.
Experience with credentialing Radiologist for initial and reappointment.
Experience with Smartsheet, as a builder or user.
Current Certified Provider Credentialing Specialist certificate.

Responsibilities

Assist the manager with day-to-day credentialing activities for radiology providers, including initial appointments, reappointments, and related follow-up tasks.
Assist with provider onboarding, recredentialing cycles, payer enrollment support, and privileging documentation to ensure timely processing.
Review credentialing files, provider rosters, and supporting documentation for completeness, accuracy, and timely updates.
Work closely with the UCH Medical Staff Office, Highlands Ranch Medical Staff Office, Children’s Hospital and other Satellite Radiology Offices, to lead new physicians through the clinical credentialing process and set up their CU Medicine billing profile in Salesforce with strict deadlines to ensure ability to practice on day one.
Create and maintain physician profiles within Salesforce.
Partnership with GME Office and Radiology Education Team for new onboarding Fellows.
Assist with the creation of database for tracking initial appointments and reappointments for medical staff.
Actively monitor provider credentials to avoid lapses in license and required certification for continuing privileges. Monitor license and credential expiration dates to ensure that lapses do not occur.
Independently manage day-to-day credentialing activities for all radiology providers, including initial appointments, reappointments, and related follow-up tasks.
Monitor credentialing volume, track turnaround times, and help resolve issues that may delay provider processing.
Partner with leadership and cross-functional teams to support process improvements, policy updates, and reporting needs.
Operate as the Department credentialing, re-credentialing and faculty onboarding subject matter expert.
Creates and maintains detailed database on MD’s and NP/PAs credentialing and licensure; responsible for data analysis, and interpretation to support Dept compliance, accreditation and clinical staffing requirements.
Assists in maintaining updated records are disseminated to appropriate authorities to keep medical staff appointments in compliance for privileges.
Maintain provider data integrity across systems to support accurate reporting, downstream operations, and compliance requirements to ensure approval for privileges on initial and reappointments.
Independently review and implement process improvement initiatives for credentialing and recredentialing medical staff within the department.
Subject matter expert in maintenance of the documentation for the verification processes used to confirm healthcare provider’s credentials and professional standing, accreditation requirements or organizational policies.