Credentialing Coordinator (Dentistry Practice Plan)

UT Health San Antonio•San Antonio, TX

About The Position

Under general supervision, the Credentialing Coordinator ensures proper credentialing and privileging for physicians, mid-level providers, research associates, professionals, and paraprofessionals within the School of Dentistry. The role maintains compliance with provider licensure, appointments with state and governmental agencies, and certifications. It also tracks completion of required continuing dental and medical education courses and workshops. The coordinator supports providers throughout credentialing and re-credentialing, prepares and submits applications and supporting documentation, monitors credentials and performance, and communicates credentialing status and outcomes to providers, departments, and external entities. The role also provides customer service and administrative support to providers, applicants, administrators, and hospitals.

Requirements

High school diploma or GED.
Ability to effectively serve customer needs.
Strong attention to detail and commitment to accuracy.
Ability to work independently under limited supervision.
Strong multitasking, organizational, and time-management skills.
Ability to monitor own work for quality and demonstrate accuracy and thoroughness.
Proficiency in relevant software, such as the Microsoft Office suite.
Strong verbal, written, and interpersonal communication skills.

Nice To Haves

Associate’s degree or higher.
Certified Credentialing Coordinator.

Responsibilities

Guide providers through credentialing and re-credentialing and ensure required documentation is completed for UT Health School of Dentistry and facilities where providers deliver services.
Work with providers to prepare and submit Medicare and Medicaid applications to the enrollment office.
Prepare credentialing applications and supporting documentation not supplied by providers, and address requests for additional information or corrections.
Verify and track credentialing and re-credentialing for physicians, professionals, and paraprofessionals at UT Health School of Dentistry and facilities where providers have privileges.
Receive credentialing applications and enter data into the credentialing system.
Work with providers to maintain compliance with licensure, appointments with state and governmental agencies, and certifications; generate monthly reports of expiring credentials.
Monitor provider performance between credentialing cycles, generate performance review documentation, share it with departments for completion, and notify external entities of provider suspensions when necessary.
Work with departments to obtain proof of professional liability coverage.
Provide support and information for monthly credentialing committee meetings and prepare reports on initial appointments and reappointments.
Notify providers and departments of credentialing status and final results, email notices, and update the credentialing system with final outcomes.
Track completion of required continuing dental and medical education courses and workshops and provide documentation to outside entities as required.
Respond to inquiries from providers, applicants, administrators, and hospitals, and provide documents to physicians or office staff upon request.
Perform other duties as assigned.