Credentialing Coordinator

One City Center • Allentown, PA

3d

About The Position

Performs all functions of the credentialing process, initial and reappointment of providers. Provides support to various Medical Staff Committees including meeting preparation, minute taking, and expediting actions through approvals process.

Requirements

• High School Diploma/GED
• 3 years of experience in a medical staff office setting and/or insurance credentialing.
• Knowledge of The Joint Commission, NCQA, Pennsylvania Dept. of Health, and Federal standards guiding the principles of credentialing and privileging.

Nice To Haves

• Associate's Degree in human resources or related field.
• CMSC - Certified Medical Staff Coordinator - State of Pennsylvania within 3 Years

Responsibilities

• Analyzes applications for appointment and reappointment.
• Identifies and incorporates DOH, HFAP, The Joint Commission, NCQA standards, and guidelines ensuring compliance by the Hospital, Staff Development Plan, and Credentials Verification Organization.
• Assists departmental Chairs/Physician in Chiefs, Division Chiefs, and Medical Directors in fulfilling respective roles in the credentialing process.
• Determines need and pursues follow-up of activity subsequent to meetings: Credentials, MEC, and Board of Trustees/Directors.
• Identifies issues and recommends for corrective action which may include modification of policies and procedures and/or Bylaws.
• Prepares for and participates in regulatory surveys and third party audits.
• Provides assistance in development and enhancement of the Medical Staff database.
• Provides assistance in the development of policies and procedures related to credentialing activities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED