Credentialing Coordinator

University of Arkansas•Little Rock, AR

5d•Onsite

About The Position

The Credentialing Coordinator supports the Professional Staff Office functions, including: primary source verifications of expirables, outpatient ordering provider processing, practitioner status requests and terminations of credentialed and managed care practitioners; Credentials Committee agenda support; credentialing file maintenance; scanning of practitioner files; project management tasks; administrative functions related to the Bylaws, Rules and Regulations, and Departmental Policies and Procedures; and regulatory compliance.

Requirements

Bachelor’s Degree OR High School Diploma/GED + 4 years of general administrative experience.
Experience in medical staff services, credentialing office, physician’s office practice, hospital admissions, medical records, or other health care related fields is preferred.
Proof of legal authority to work in the United States on the first day of employment.

Responsibilities

Coordinate the credentialing and re-credentialing process for physicians, advanced practice providers, and other clinical practitioners.
Collect, verify, and maintain provider credentials, including licenses, certifications, education, training, work history, and professional references.
Process initial appointments, reappointments, privileging, and credentialing applications in accordance with organizational policies and regulatory requirements.
Conduct primary-source verification of licenses, certifications, DEA registrations, malpractice coverage, education, training, and other required credentials.
Prepare credentialing files and applications for review by medical staff leadership, credentialing committees, and governing bodies.
Monitor expiration dates and ensure timely renewal of licenses, certifications, registrations, and other provider credentials.
Maintain accurate and confidential provider credentialing records in electronic databases and credentialing systems.
Communicate with providers, medical staff offices, licensing boards, hospitals, insurance companies, and other external organizations to obtain required documentation.
Identify incomplete or discrepant information and follow up with providers and appropriate departments for resolution.
Assist with provider privileging by ensuring requested clinical privileges are supported by appropriate education, training, experience, and documentation.
Track credentialing applications and provide status updates to providers and leadership.
Ensure credentialing activities comply with applicable regulatory, accreditation, and organizational standards.
Assist with audits and surveys by preparing credentialing documentation and reports.
Maintain confidentiality of sensitive provider and organizational information.
Collaborate with Medical Staff Services, Human Resources, Provider Enrollment, Compliance, Legal, and clinical departments.