University of Rochester
Healthcare
CredentialingCoordinator
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Credentialing Coordinator at University of Rochester. Skills: Credentialing, Privileging, Primary source verification. Participate in departmental activities. Serve as a resource”
Industry & Context.
Discrepancy investigation; Discrepancy validation
What They're Looking For.
Must Have
Associate's degree in business or healthcare related field, 2 years of medical administrative experience, 1 year of medical credentialing and/or payer enrollment experience
Nice to Have
Knowledge of Joint Commission, CMS, and NCQA Regulations, Experience with database applications, Exceptional interpersonal and communication skills, Ability to develop and maintain relationships
What You'll Do.
Participate in departmental activities
Collaborate with team members
Determine practitioner eligibility
Analyze application and supporting documents
Inform practitioner of application status
and evaluate information
Ensure compliance with accreditation and regulatory standards
Validate accuracy of applications
Conduct background investigation
Perform primary source verification
and validate discrepancies
Ensure review and approval bodies have information
Process requests for privileges
Ensure compliance with criteria
Monitor initial and reappointment process
Ensure appointments are processed
Meet regulatory requirements
Monitor status of completed files
Ensure compliance with regulatory standards
Monitor personal performance statistics
Communicate with managers
Review performance measures and goals
Collaborate and coordinate activities
Collaborate with various departments
Ensure all policies and standards are met
Communicate status of applicant files
Coordinate efforts to obtain necessary information
Ensure deadlines are met
Communicate status of expiring credentials
Coordinate efforts to obtain necessary documentation
Serve as a resource for departments
Respond to inquiries from other healthcare organizations
Interface with internal and external customers
Review and assess departmental functions
Identify areas in need of improvement
Assist with credentialing expirables process
Represent the Medical Staff Services Department
Serve as back up to other credentialing staff
Serve as Team Peer Interviewer
Perform other duties as assigned
How You'll Work.
Team & Collaboration
Collaborate with other team members; Collaborate with various departments; Collaborate with management
Communication Scope
Interpersonal skills; Communication skills
Full Job Description
As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. _**Job Location (Full Address):**_ 135 Corporate Woods, Rochester, New York, United States of America, 14623 _**Opening:**_ Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910397 URMC Medical Staff Services Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job 's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ _**Responsibilities:**_ Participates in departmental activities to ensure quality in conducting, maintaining, and communicating the medical and allied health professional staff credentialing, privileging, and primary source verification process. Serves as a resource of the department, and collaborates with other team members to advance the quality of practitioners and patient safety of the facility. **ESSENTIAL FUNCTIONS** * Determines practitioner eligibility for membership/participation. Analyzes application and supporting documents for accuracy and completeness and informs the practitioner of the application status, including the need for any additional information or corrections. Obtains, researches, and evaluates information from primary sources to ensure compliance with accreditation and regulatory standards to validate the accuracy of applications for one or more decision making bodies,
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