Credentialing Coordinator

Credentialing Coordinator

JOIN THE CAIMA TEAM!

California Advanced Imaging Medical Associates’ (CAIMA) administrative team provides support to CAIMA’s physicians so they can focus on what matters most – providing state of the art, accurate, comprehensive, and compassionate radiology services to patients. CAIMA is the largest private radiology group in the West Bay Region and provides radiology services in hospitals and outpatient imaging centers stretching from San Mateo through San Francisco into Marin, Sonoma, and Lake Counties.

We are looking for a Credentialing Coordinator that will contribute to the team’s success. This is an in-person position, Monday – Friday, working from our administrative office located in Novato, CA.

Summary Description

Reporting to the Operations Manager, you will assist in the credentialing process for medical group clients of California Advanced Imaging Medical Associates (CAIMA) by completing state license and medical staff privilege applications, maintain accurate and complete files on each physician, and ensure that all licenses and credentials are current. You will communicate with physicians, physician licensing authorities, hospitals, and other outside agencies, and maintain confidentiality as appropriate.

Assists Operations Manager in developing and implementing policies and procedures to optimize credentialing, scheduling, physician onboarding, site management, and other activities as assigned.

Essential Duties and Responsibilities:

Credentialing

• Completes payer enrollment applications for physicians and medical groups through web portals (PAVE, PECOS, CAQH, Availity, Maximus, etc.) to ensure provider numbers are obtained in a timely manner.
• Perform credentialing and privileging duties as assigned, including but not limited to the processing of applications for appointment and reappointment, completing a thorough review and analysis of practitioner applications, identification and follow up of "red flag" items, and preparing files for review and recommendation by the medical staff.
• Manages expiration and renewal of licenses, permits, certifications, health records, as well as annual dues and application fees. Ensures accuracy of all information collected.
• Maintains electronic credentials files, clinical privilege forms (as assigned), CME, OPPE and practitioner databases to ensure information contained is accurate and current. Effectively utilizes software to perform essential job functions, adhering to established data entry conventions.
• Perform electronic, written, and telephonic queries to agencies providing primary source information regarding malpractice claims, licenses, certifications, training and affiliations. Assess content of responses to determine any follow up required.
• Participates in facility/credentialing preparation for site visits and licensing/accreditation surveys.
• Complete out-of-state medical license applications for physicians applying for medical licensure in those states and assist with licensing processes to ensure that physicians obtain licenses and other required credentials to practice in that state
• Supports Operations Manager and Administrative team to coordinate project tasks and deliverables.
• Observing, reviewing and analyzing processes to identify improvement opportunities.
• Assists in the development of operational policies and procedures related to physician scheduling, site management, credentialing, professional liability insurance issues, physician onboard, and other duties as assigned.
• Ensure compliance with current healthcare regulations, laws, and ethical standards.

Qualifications:

Education and Experience

• Bachelor’s degree in business or a related field, 3-5 years related experience; or equivalent combination of education and experience
• Experience working in healthcare administration, preferably radiology.

Knowledge, Skills, and Abilities

• Demonstrates strong business acumen, interpersonal skills, professionalism, and leadership.
• Delivers exceptional customer service to all stakeholders.
• Communicates and influences effectively in written and oral form.
• Versatile, flexible, and adapts to changing priorities.
• Comfortable working independently with minimal guidance.
• Exhibits confidence in self and others; inspires and motivates self and others to perform well.
• Comfortable working with all levels of leadership.
• Ability to prioritize responsibilities and organize workload.
• Demonstrates attention to detail and accuracy.
• Ability to analyze and interpret professional journals, technical procedures, or government regulations.
• Ability to generate reports, business correspondence, and procedure manuals.
• Proficient with Microsoft Office applications including Outlook, Word, and Excel.
• Ensure confidentiality, follow HIPAA guidelines, and protect sensitive materials.
• Experience with credentialing software preferred (MD-App, Verity Hub, RLDatix)

Benefits:

• Competitive Wage
• Medical, Dental, and Vision Plans
• 401k Plus Company Profit Share
• Paid Holidays and Vacation
• Life Insurance
• Identity Theft and Pet Insurance

Work Location: In-person

Equal Opportunity Employer

Job Type: Full-time

Pay: $65,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to Commute:

• Novato, CA 94945 (Required)

Work Location: In person

Salary : $65,000 - $75,000