Credentialing Coordinator

CommonSpirit Health•Kearney, NE

12h•Onsite

About The Position

This Credentialing Coordinator position contributes to the mission and vision of CHI Health by assuring the CHI Health physicians and advanced practice providers (APPs) are properly credentialed and privileged to care for patients across CHI Health. The overall function and responsibility of this position is to ensure the continuous and accurate credentialing and initial privileging of physicians and APPs, maintaining a centralized credentials file for all CHI Health providers with accurate and current documentation, deprivileging of providers every two years, and communicating and coordinating with appropriate clinic personnel to achieve these. Discretion is required at all times in sensitive and confidential matters. All of these functions must be performed in cooperation with CHI Health management staff and the Clinical Quality Committee (CQC). Completes all new clinic providers credentialing and /or provides oversight with the privileging process to ensure all necessary documentation is available to grant billing, hospital, and practice privileges. This includes working with providers to obtain information and time-sensitive renewal documentation with the expedient completion of the following, but not limited to: Maintains an accurate, current, centralized credential file for all providers in CHI Health. Processes all recredentialing requests for CHI Health providers based on regulatory time and content requirements. Obtains verification of licensure, malpractice insurance/information/history, etc., required certificates (e.g. medical school diploma, residency training, board certification, etc.) directly from the provider or through communication with the appropriate clinic liaison in a timely fashion prior to initial privileging review by the Medical Executive Officer and CQC. Alerts appropriate clinic management staff of potential risks or conflict issues that may arise from any of the privileging, credentialing, and deprivileging processes. Notifies the appropriate personnel of revisions in the demographic information of CHI Health providers to maintain the most current data base that may require access by hospital personnel, insurance companies, PHO, etc. On a continuous basis, secures proof of malpractice insurance coverage, state licensure and DEA certifications. Processes applications in an expedient and thorough manner for presentation to System Credentials Committee, Medical Executive Committee(s), AH Board, CQC, and AHC Board through a centralized credentialing/privileging process.

Requirements

High School Degree

Responsibilities

Assuring physicians and advanced practice providers (APPs) are properly credentialed and privileged.
Ensuring continuous and accurate credentialing and initial privileging of physicians and APPs.
Maintaining a centralized credentials file for all CHI Health providers with accurate and current documentation.
Deprivileging of providers every two years.
Communicating and coordinating with appropriate clinic personnel.
Completing all new clinic providers credentialing and/or providing oversight with the privileging process.
Granting billing, hospital, and practice privileges.
Working with providers to obtain information and time-sensitive renewal documentation.
Maintaining an accurate, current, centralized credential file for all providers in CHI Health.
Processing all recredentialing requests for CHI Health providers based on regulatory time and content requirements.
Obtaining verification of licensure, malpractice insurance/information/history, and required certificates.
Alerting appropriate clinic management staff of potential risks or conflict issues.
Notifying appropriate personnel of revisions in demographic information of CHI Health providers.
Securing proof of malpractice insurance coverage, state licensure, and DEA certifications.
Processing applications for presentation to System Credentials Committee, Medical Executive Committee(s), AH Board, CQC, and AHC Board.