Credentialing Coordinator - Full time - REMOTE - (VA,NC, SC, TN, WV, TX, MD )

VCU Health • Richmond, VA

16h • Remote

About The Position

The Credentialing Coordinator is responsible for all aspects of the initial credentialing, re-credentialing and privileging functions for all clinicians on medical and allied health staff at the VCU Health System Hospitals. The Coordinator includes interacting with clinicians to obtain applications and pertinent documents evaluating data for accuracy and completeness, monitoring receipt and follow up responses ensuring timely and efficient processing. This position notifies supervisor Director of any adverse, incomplete or questionable data. This job works independently and is able to assess a situation, consider alternatives and choose the appropriate course of action. This job demonstrates sound organizational ability and effectively sets priorities. This job must be able to maintain strict confidentiality and professional discretion. This job ensures compliance with hospital bylaws, and with local, state and federal requirements. This job provides assistance to the Director in development, plans, organization and control of the operation of the Medical Staff Office in order to meet the mission and goals of the hospital and the requirements of the Medical Staff Bylaws, JCAHO, NCQA Standards and other applicable federal, state and local regulatory and/or accrediting agencies. This job attends medical staff committee meetings as directed. Interacts and provides support services to medical staff officers, departments and chairs as assigned.

Requirements

• Minimum of three (3) years previous credentialing and medical terminology experience in a hospital or managed care credentialing setting.
• Previous experience using a personal computer and various applications, including Microsoft Office Access, Word, and Excel and credentialing software.
• Associates or Bachelors degree or experience in lieu.
• Organizational skills, proficiency in MS Office Access, Word, and Excel and credentialing software, and numerous hospital databases with extreme attention to detail.
• Ability to multi-task in stressful and limited time constrained environment.
• Must possess knowledge of local, federal and state laws and regulations and JCAHO standards related to position’s chief objective and demonstrate aptitude for compliance with VCUHS policies, procedures, and customer service philosophy.

Nice To Haves

• Certified Provider Credentialing Specialist (CPCS) preferred.
• Five (5) years of previous experience in credentialing in a health care environment.
• Previous experience with the application of JCAHO, URAC and NCQA guidelines.
• Certified Professional in Medical Services Management (CPMSM).
• Associates or Bachelors Degree in Business, Healthcare or closely related field.

Responsibilities

• Responsible for all aspects of initial credentialing, re-credentialing, and privileging functions for clinicians.
• Interact with clinicians to obtain applications and pertinent documents.
• Evaluate data for accuracy and completeness.
• Monitor receipt of documents and follow up on responses to ensure timely and efficient processing.
• Notify supervisor Director of any adverse, incomplete, or questionable data.
• Ensure compliance with hospital bylaws, and local, state, and federal requirements.
• Provide assistance to the Director in the development, planning, organization, and control of the Medical Staff Office operations.
• Attend medical staff committee meetings as directed.
• Interact and provide support services to medical staff officers, departments, and chairs as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree