CREDENTIALING COORDINATOR

CREDENTIALING COORDINATOR JOB SUMMARY

The Credentialing Coordinator is responsible for the day to day processes for both FTCA/HRSA and payer Credentialing and Privileging programs of Comprehensive Community Health Centers. Ensures timely and accurate Credentialing and Privileging of all CCHC physicians and non-physician licensed professionals. The Credentialing Coordinator is responsible for maintaining the credentialing database platform.

CREDENTIALING COORDINATOR ESSENTIAL DUTIES AND RESPONSIBILITIES

• Coordinates and administers the Credentialing and Privileging process for all CCHC providers and non-physician licensed professionals.
• Maintain the Credentialing database platform.
• Coordinates compliance for legal and regulatory documentation for the professionals of CCHC.
• Monitors accuracy of policies and procedures, ensuring compliance with accrediting organization requirements. 
• Create CAQH profiles for providers.
• Responsible for ensuring that all providers are contracted with different payers, including HMO's, Medi-Cal and Medicare.
• Coordinate with the payer to ensure that all Credentialing requirements are met.
• Submit Credentialing forms and applications to IPA’s, Medical Groups and Plans as needed. 
• Follow-up on submitted applications with IPA’s, Medical Groups and Plans.
• Functions as a credentials and privileging contact for all internal and external inquiries. 
• Assist in developing innovative tools, features, and work flows to improve the Credentialing and Privileging processes.
• Works closely with HR to obtain all necessary documents for Credentialing and Privileging.
• Performs miscellaneous job-related duties as assigned.

CREDENTIALING COORDINATOR EDUCATION AND EXPERIENCE

• Bachelor’s in a health-related field preferred.
• Credentialing knowledge and familiarity with industry standards required.
• Knowledge of Community Health Centers (CHC) and HRSA clinical staffing requirements preferred

 CREDENTIALING COORDINATOR KNOWLEDGE, SKILLS AND ABILITIES

• Ability to find solutions when barriers are identified.
• Strong documentation skills. 
• Ability to multi-task and prioritize when needed.
• Ability to independently seek out resources and work collaboratively.
• Ability to read, understand and follow oral and written instructions. 
• Experience and work ethics that supports working within a high functioning, team-oriented environment.
• Demonstrates a willingness and ability to work under supervision.
• Ability to develop and maintain good working relationships with staff.
• Ability to use computer and learn new software programs.
• Excellent interpersonal skills reflecting clarity and diplomacy and the ability to communicate accurately and effectively with all levels of staff and management.
• Demonstrates ability to work in a regulatory climate that includes oversight of state and federal entities, payer contracts etc.
• Possesses ability to communicate effectively, both verbally and in writing.
• Possesses genuine respect for others and acceptance of their individual social and cultural traits.
• Proficient knowledge of Microsoft Outlook.
• Able to travel and attend professional meetings, conferences, trainings and clinic sites. 
• Demonstrate flexibility, enthusiasm, and willingness to cooperate while working with others in multi-disciplinary teams.
• Performs other related duties as assigned.

 CREDENTIALING COORDINATOR PAY RATE: $25-$27/hr

 CREDENTIALING COORDINATOR BENEFITS:

• Medical, Dental and Vision – 100% paid by Employer
• Life Insurance and Accidental Dismemberment – 100% paid by Employer
• Paid Holidays
• Paid Time Off
• Wellness Day Off
• 401(k) and 401(k) matching
• Flexible Spending Account
• Fringe
• Supplemental Insurance

Compensation details: 25-27 Hourly Wage

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