Credentialing Coordinator

Position Summary

This position is responsible for providing assistance in the Human Resources Department (HR) with the credentialing and privileging of all HCHN providers and assisting with day-to-day operations pertaining to the administration of HR policies, procedures and programs.

General Responsibilities

• Assists with maintaining provider credentialing in compliance with JCAHO, HCHN policies, DOL and all other governing organizations.
• Is familiar with all aspects of the credentialing process, including updating physicians' applications for credentialing, functions as a liaison between the credentialing organizations and HCHN, and notifying the physicians when their licenses and applications need to be updated.
• Attends training seminars and conferences to maintain knowledge of insurance and HMO requirements.
• Maintains communication between medical staff, patients and insurers.
• Assists with the credentialing and re-credentialing of all physician and mid-level providers according to Health Plan specifications.
• Is familiar with and capable of processing all aspects of the privileging process for providers.
• Maintains accurate, organized, and confidential credentialing and privileging records, files and applications for all HCHN providers.
• Ensures all licensure, certifications, and hospital privileges are current.
• Works independently with providers and Health Plans to research and resolve credentialing-related issues.
• Works conjointly with the providers to ensure CME credits and other trainings are documented.
• May participate in recruitment functions by posting jobs on various job boards, local agencies, and colleges/universities; participate in job fairs.
• Conducts reference and background checks and verifications of employment.
• Assists with new hire training and orientation.
• Consistently answers questions and handles processes related to employment, benefits, recruitment and general HR issues.
• Performs other duties as assigned.

Education and/or Experience

Required:

• Associates degree in Business or related field from an accredited college or university
• At least three (3) years of HR and/or credentialing experience equivalent to that listed in the general responsibilities;

Preferred:

• Bachelors degree in Business Admin, Human Resources or a related field
• Previous experience credentialing physicians and mid-level providers for a healthcare organization
• At least two (2) years of work experience in a health care organization.

OR

• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the job as listed above.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to maintain confidentiality in all matters.
• Ability to formulate decisions and make judgments that are demanding and interpretive.
• Flexible, with the ability to work independently and with minimal guidance.
• Excellent concentration skills and must be detail oriented.
• Extensive working knowledge of Microsoft Office.
• Excellent interpersonal and customer service skills, to effectively and tactfully deal with a diverse group of patients, staff, customers, and community groups.
• Ability to communicate effectively with diverse populations.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to talk or hear.
• The employee frequently is required to stand, walk, sit; use hands to handle or feel; reach with hands and arms; and stoop, kneel, or crouch.
• The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision requirements include the ability to see at close range.
• Fine hand manipulation (keyboarding).

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Internal office space.
• The noise level in the work environment is usually moderate.

We are an EEO employer, and all hiring practices and other terms and conditions of employment shall be maintained and conducted in a manner that ensures compliance with all applicable federal laws.

Job Type: Full-time

Pay: From $45,000.00 per year

Benefits:

• 401(k)
• AD&D insurance
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• Associate (Required)

Experience:

• Human resources or Credentialing: 3 years (Required)

Work Location: In person

Salary : $45,000 - $0