Summit Pacific Medical Center
Healthcare
CredentialingCoordinator
“Credentialing Coordinator at Summit Pacific Medical Center. Skills: Credentialing, Provider data management, Regulatory knowledge. Manage credentialing and recredentialing processes for medical staff providers. Verify provider education, training, licensure, and certifications”
Industry & Context.
Ability to work independently using good judgment, problem-solving, organization, and prioritization skills
Occasional travel may be required for training or meetings
What They're Looking For.
Must Have
High School diploma or GED minimum, 2 years of experience in healthcare credentialing or related field, Knowledge of accreditation standards, state, and federal regulations related to credentialing, organizational skills, ability to prioritize, and reprioritize work as needed to meet objectives, Professional and effective written and verbal communication skills, Ability to identify and employ communication strategies appropriate to the audience, Grammar and punctuation skills as needed to compose professional documents, Proficient in the use of current technology and software, including intermediate to advanced Microsoft Office skills (Word, Excel, Outlook), Proven ability to handle confidential information with discretion, Ability to develop and maintain accurate documentation and records, Demonstrated teamwork and collaboration skills, customer service and interpersonal ability to maintain composure and interact calmly and professionally with co-workers, providers, patients, and visitors in a fast-paced, high-stress environment, Ability to work independently using good judgment, problem-solving, organization, and prioritization skills to complete assignments in a timely, accurate, and effective manner
Nice to Have
Associates degree preferred, CPCS (Certified Provider Credentialing Specialist) certification preferred
What You'll Do.
Manage credentialing and recredentialing processes for medical staff providers
Verify provider education
Coordinate with insurance payer enrollment specialists for provider enrollment
Ensure compliance with regulatory standards and institutional policies
Coordinate privileging and credentialing process for medical staff providers
research application details
Assure process is in accordance with Medical Staff Bylaws and SPMC policies
Coordinate re-credentialing and reappointment processes
Prepare monthly files for Medical Executive Committee and Board of Commissioners
Submit complete and current provider information to insurance payer enrollment specialists
Enter and maintain accurate provider information in paper files
credentialing databases
Prepare for and participate in internal and external audits
Stay current with changes in credentialing standards and requirements
Communicate with providers regarding upcoming time-sensitive licensures
Obtain necessary information and documentation from providers
Document detailed and organized records of all credentialing activities
Generate reports on credentialing activities and status
Coordinate provider onboarding with internal departments
Schedule and track completion of onboarding provider’s Focused Professional Practice Evaluations (FPPE)
Assist Senior Medical Leaders with scheduling provider interviews
Provide additional recruitment support as needed
Perform special projects and duties as assigned
How You'll Work.
Team & Collaboration
Works closely with insurance payer enrollment specialists; Communicates with providers; Coordinates provider onboarding with internal departments such as admin, HR, IT and finance; Assists Senior Medical Leaders; Demonstrated teamwork and collaboration skills; Interact calmly and professionally with co-workers, providers, patients, and visitors
Communication Scope
Professional and effective written and verbal communication skills; Ability to identify and employ communication strategies appropriate to the audience; Grammar and punctuation skills
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