Credentialing Coordinator - Medical Staff Office

University Physicians' Association•Knoxville, TN

11h•$23 - $26•Hybrid

About The Position

University Physicians’ Association (UPA) is seeking a dynamic, experienced Credentialing Coordinator to join our high-performing Medical Staff Office (MSO) team. The Credentialing Coordinator is responsible for coordinating and processing initial credentialing applications for Advanced Practice Providers (APPs), including Nurse Practitioners, Physician Assistants, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists, and other licensed practitioners. This position ensures the timely and accurate collection, verification, and review of credentialing documentation while maintaining compliance with organizational policies, regulatory requirements, Joint Commission accreditation standards, and applicable state and federal regulations.

Requirements

High school diploma or equivalent.
Minimum of two years of administrative, healthcare, credentialing, medical staff services, or related experience.
Strong organizational skills with exceptional attention to detail.
Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and Teams.
Excellent written and verbal communication skills.

Nice To Haves

Previous credentialing, medical staff services, provider enrollment, or healthcare administration experience.
Knowledge of credentialing standards and regulatory requirements, including Joint Commission, NCQA, CMS, and state licensing boards.
Experience with credentialing software and provider databases.
Certified Provider Credentialing Specialist (CPCS) or willingness to obtain certification.
Strong analytical and problem-solving abilities.
Ability to interpret credentialing requirements, policies, and regulatory standards.
Exceptional customer service and relationship-building skills.
Ability to work independently while collaborating effectively with cross-functional teams.
Strong attention to detail and commitment to accuracy.
Ability to handle confidential information with discretion and professionalism.

Responsibilities

Coordinate and manage the initial credentialing process for Advanced Practice Providers from application receipt through final approval.
Review applications for completeness and accuracy, identifying missing or incomplete information and following up with applicants as needed.
Perform primary source verification of licensure, education, training, board certification, work history, professional references, malpractice coverage, and other required credentials.
Monitor credentialing timelines to ensure files progress efficiently and meet established turnaround goals.
Communicate with providers, practice managers, department leaders, and external agencies regarding credentialing requirements and application status.
Prepare credentialing files for committee review and approval.
Maintain accurate credentialing records and electronic databases.
Ensure compliance with Joint Commission standards, NCQA guidelines, CMS Conditions of Participation, state regulations, and organizational policies.
Track expiring credentials and assist with ongoing maintenance of provider records.
Generate reports and provide status updates regarding credentialing activities.
Participate in process improvement initiatives to enhance credentialing efficiency and provider onboarding experiences.
Maintain confidentiality of sensitive provider information and organizational data.
Attend Credentials Committee, Advanced Practice Oversight Committee and any other meetings that are requested and complete any follow-up needed.
Adhere to UPA & UTMC bylaws, rules & regulations, policies & procedures and regulatory requirements.