Credentialing Coordinator

Description

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

This a hybrid role - 2 days per week in-office required.

Do you have the career opportunities as a Credentialing Coordinator you want with your current employer? We have an exciting opportunity for you to join HealthONE Colorado Care Partner which is part of the nation's leading provider of healthcare services, HCA Healthcare.

Benefits

HealthONE Colorado Care Partner, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Free counseling services and resources for emotional, physical and financial wellbeing
    
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
    
  • Employee Stock Purchase Plan with 10% off HCA Healthcare stock
    
  • Family support through fertility and family building benefits with Progyny and adoption assistance.
    
  • Referral services for child, elder and pet care, home and auto repair, event planning and more
    
  • Consumer discounts through Abenity and Consumer Discounts
    
  • Retirement readiness, rollover assistance services and preferred banking partnerships
    
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
    
  • Colleague recognition program
    
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
    
  • Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

  Learn more about Employee Benefits

  Note: Eligibility for benefits may vary by location.

  Our teams are a committed, caring group of colleagues. Do you want to work as a(an) Credentialing Coordinator where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!

  Job Summary and Qualifications

  Responsible for supporting the credentialing functions of the HealthONE facilities.

  DUTIES INCLUDE BUT ARE NOT LIMITED TO:
  

  Complete file review for initial and reappointment applications from doctors and advanced practice professionals at the time the application is released from the Credentials Processing Center (CPC). File review includes reviewing the following elements and completing any necessary follow up:

  Application and HealthONE Addendum Application

  Privileges

  Primary Source Verifications (education, training, affiliations, work history, peer references, certifications, licensure, DEA, gaps in time, NPDB, background, etc. )

  Dynamic credentials (insurance, etc. )

  CME/CEUs

  HealthStream Courses

  Life Support Certifications

  Immunizations (i. e. , PPD, flu)

  Case logs/activity

  CV/Resume

  Supporting documents (i. e. , Authorization/Attestation/Release, Confidentiality and Security Agreement, Practitioner Acknowledgement, Pharmacy Signature, etc. )

  Market forms (HIM electronic signature/edit, MRSA, HealthONE Medical Staff Code of Conduct, Physician Referral Services, APP orientation acknowledgement form, Medical Necessity/Reflex Testing, etc. )

  Red/Yellow flags

  CPHP and/or CPEP reports, if required.

  Aging Provider Assessment for providers 70 and older

  Build new providers and update existing providers in the Meditech Provider Dictionary for RFCs/RRFCs

  Build new providers in eSAF and HealthStream/Physician Learning Center

  Pull case logs/activity reports, if needed

  Complete data entry in the Cactus database (i. e. , as it relates to the Physician Referral Services Form, Health record, etc. )

  Submit Provider Action Forms as necessary for demographic changes, etc.

  Review all information received and verify completeness and accuracy on content in accordance with policies and procedures.

  Communicate with applicants or their practices and HealthONE facilities regarding many facets of credentialing.

  Transmit documents to the CPC, Alchemy, and HealthONE based on policy and procedures.

  Comply with company and department policies/procedures.

  Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement.

  KNOWLEDGE, SKILLS & ABILITIES:

  Maintain working knowledge medical staff credentialing and regulatory requirements.

  Good working knowledge of general/basic office skills, including computer skills, typing skills, filing, business communications including grammar and spelling skills, basic mathematical calculations, etc.

  Ability to organize and prioritize efficiently and effectively.

  Ability to maintain confidentiality of privileged information gained as a result of job functions.

  Strong interpersonal skills.

  Excellent teamwork skills.

  Adept at relationship building.

  Understand the issues related to credentialing.

  Ability to adapt to changing company and departmental needs.

  Proficient in Microsoft Office applications, Internet searches, and relevant data bases.

  Ability to work independently and under pressure to follow through on issues.

  Ability to communicate ideas clearly and concisely, in an effective and appropriate manner, both verbally and in writing, with all levels of customers.

  Ability to establish and maintain long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.

  Ability to work effectively with colleagues, customers, including Medical Staff leaders.

  High degree of accuracy, timeliness, and attention to detail.

  What qualifications you will need:

  • High school graduate or GED with college course work in Medical Staff Service Sciences, Business or a related field of study, or an equivalent combination of training and experience.
  • Minimum of two years experience preferred in professional credentialing in a healthcare facility (i. e. , Medical Staff Office), managed care setting, or credentials verification organization.
    
  • Certified Provider Credentialing Specialist or Certified Profession in Medical Service Management.