Credentialing Coordinator Lead

UT Health San Antonio•San Antonio, TX

About The Position

Under minimal supervision, the Credentialing Coordinator Lead is responsible for timely facilitating the management and coordination of the complex credentialing and privileging process of physicians, mid-level Providers, research associates, professionals, and paraprofessional individuals across multiple facilities in and outside San Antonio, Texas. The Credentialing Coordinator Lead will also assist in initiating and facilitating the Provider Enrollment process for billing. The Credentialing Coordinator Lead initiates access for providers Epic and other software and ensures information is accurate and updated. The Credentialing Coordinator Lead will maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications, as well as Professional Liability coverage for each Provider. The Credentialing Coordinator Lead also tracks and ensures the completion of required continuing medical education courses/workshops. Due to the complexity, the Credentialing Coordinator Lead must be a self-starter that is able to adapt, multi-task, and understand the intricate credentialing and enrollment needs depending on the provider's specialty. Mentors, provides guidance, and assists in training to lower level team members.

Requirements

Demonstrates analytical thinking and ability to organize work.
Advanced Ability to effectively serve the customer’s needs, detail oriented.
Advanced Strong attention to detail and ensuring accuracy.
Ability to work independently with strong attention to accuracy.
Advanced Strong multitasking and organizational skills.
Advanced Exhibits accuracy and thoroughness; monitors own work for quality.
Advanced Strong organizational and time management skills.
Advanced Proficiency in relevant software such as MS Office suite.
Advanced Strong verbal, written and interpersonal communication skills.

Responsibilities

Coordinates and facilitates day to day duties of Credentialing Coordinators.
Responsible for mentoring, providing guidance, and assist in training to Credentialing Coordinators.
Guide Provider through credentialing and re-credentialing process and ensure the completion of required documentation for UT Health and all facilities where the Provider delivers services.
Works with Provider to prepare and submit Medicare & Medicaid applications to enrollment office.
Prepare all credentialing applications; develop and provide documentation that are not supplied by the Provider; address any additional information or corrections requested.
Verify and track the proper credentialing and re-credentialing of physicians, professionals, and paraprofessional individuals within UT Health and all facilities where the Provider has privileges.
Receive credentialing application and enter data into credentialing system.
Ensure submitted applications are complete, accurate and timely.
Maintain accurate and detailed files.
Work with Provider to maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications for each Provider, generate monthly report of expiring credentials.
Ensure ongoing monitoring of performance between credentialing cycles, generate performance review documentation, share with department for completion, and notify external entities when a Provider has been suspended, if necessary.
Work with Departments to establish and maintain proof of Professional Liability coverage.
May provide support and information needed for monthly credentialing committee meetings, provide report to the committee of initial and reappointments.
Notify Providers and Departments of credentialing status and final result, email notice to department and provider, ensure credentialing system (currently MD Staff) is updated with final credentialing result.
Ensure UT Health website accurately reflects Provider’s credentials once cleared.
Updates critical and time sensitive provider change of statuses when needed. Changes include adding/removing practice locations, Epic data, department transfers, supervision, name changes, and other information as needed.
Track and ensure the completion of required continuing medical education courses/workshops; provide documentation to outside entities according to requirements.
Conduct customer service tasks such as responding to Provider, applicants, administrators, and hospital inquiries; provide documents to physicians/office staff seeking copies.
Perform all other duties as assigned.
Ensures weekly credentialing status report is up to date.
Performs all other duties as assigned.