Credentialing Coordinator I

Geisinger

23h • Remote

About The Position

Conducts background investigations on physicians and other providers applying for affiliation including licensure, education and post-graduate clinical training, board certification, disciplinary actions and other professional sanctions, malpractice history, and peer assessment of current competence at time of appointment, reappointment, and cross credentialing.

Requirements

• High School Diploma or Equivalent (GED)- (Required)
• Minimum of 2 years-Healthcare (Required)
• Communication
• Computer Literacy
• Credentialing
• Professional Presentation
• Working Independently

Responsibilities

• Reviews and analyzes physician applications and credentialing documents including certificates of education, residency and fellowship training, board certification and eligibility, licensure, professional work history, liability insurance and malpractice history.
• Assesses completeness of information and providers' qualifications relative to established standards.
• Reviews and analyzes primary source verification for licensure, certification or registration required to practice a profession.
• Requests, maintains, and ensures competency data is present at appointment and re-appointment.
• Maintains tracking of all new provider s drug screening, background checks, child abuse clearance, finger printing, code of conduct, disruptive practitioner policies, current clinical competency data and Health Service information for new providers.
• Immediately reports to manager any collected information which may be averse to an applicant.
• Identifies and flags adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for credentialing review.
• Maintains a working knowledge of applicable regulatory agencies.
• Maintains an understanding of the third-party payor requirements.
• Prepares and screens, mails letters, tracks and responds daily.
• Employs public relations skills in a wide variety of phone contacts with external sources for purposes of soliciting information essential to credentials investigations, including licensing agencies; university and hospital training program administrators; certification boards; liability insurance carriers; hospital officials and credentials staff; and physicians and their office staffs.
• Organizes and maintains physician files and information following confidentiality guidelines, performs varied clerical support functions.
• Internally audits and maintains physician files in accordance with established principles of legal documentation and confidentiality.
• Prepare all files monthly for Credentials Committee review and follow-up on Credentials Committee Decisions.
• Establish and maintain excellent relationship and good communication channels with physicians, office staff, and practice administrators.
• Assist with Special projects (i.e., physician education, JCAHO and Department of Health Preparation, clinical competency data, life supports)
• Prioritize to meet deadlines on daily work and special projects.
• Maintain a thorough understanding of the standards of JCAHO, Department of Health, Bylaws, Rules and Regulation of the Medical Staff, and other regulatory agencies as appropriate.
• Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.

Benefits

• We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.
• Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.
• We know that a diverse workforce with unique experiences and backgrounds makes our team stronger.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees