Senior Credentialing Coordinator
Company: Christus Health
Posted on: September 4, 2021
The Credentialing Coordinator serves as the first line of
defense in Health Plan Quality through the functions of providing
for adequate and qualified Medical Staff. Under supervision of the
Credentialing Manager, the Credentialing Coordinator is responsible
for the all aspects of the Credentialing process. Duties include
ensuring that the health plan and its providers comply with
regulatory and accrediting agencies, interpreting standards, and
identifying, recommending and implementing changes. This position
serves as the liaison between the plan administration and the
medical staff on matters such as credentialing. This includes, but
is not limited to, verification of education and training;
certification and clinical practice submitted by physicians and
allied health professionals. The Medical Staff Credentialing
Coordinator demonstrates leadership through the role of advisor to
the medical staff and administration in understanding and applying
the standards that the medical staff must meet. This position is
responsible for developing and maintaining all aspects of the
credentialing function, including credentialing practitioners,
facilities, and ancillary services both for initial appointment and
re-appointment. The Medical Staff Credentialing Coordinator guides
health plan leadership and medical staff through such functions
such as credentials committee meetings. The Medical Staff
Credentialing Coordinator is able to advise the medical staff
leadership on matters of priority in an expeditious manner and can
instruct them in the responsibilities of their positions with
respect to credentialing and help bring them up to date on current
issues involving regulatory agencies, clinical privileges, and
standards of care. The Credentialing Coordinator should demonstrate
strong organizational skills and assertiveness in problem
- Responsible for all aspects of Credentialing of Institutional
and Individual Providers.
- Preceptor to others in duties related to
- Cross-trains other staff for major job responsibilities as
appropriate for optimum functioning.
- Serves as liaison between the medical staff and plan
- Oversees medical staff credentialing activities during initial
- Oversees medical staff credentialing activities during
- Precepts and mentors designated medical staff personnel.
- Coordinates medical staff with regulators.
- Assist with facilitation of Medical Staff meetings.
- Responsible for all phases of preparation for Medical Staff
Credentialing meetings, including production of agenda, documents
for review and for personal review and preparation of medical staff
in advance as needed to facilitate informed
- Responsible for accurate and timely recording of minutes of all
Medical Staff Credentialing meetings.
- Assists medical staff in enforcing medical staff bylaws, rules
and regulations, policies and procedures, and identifies
/communicates the need for revisions and additions as needed.
- Tracks, on an on-going basis current licensure required for
physicians and allied health professionals.
- Records and tracks medical staff meeting attendance, as
required by medical staff bylaws for maintaining staff status.
- Provides support for medical staff and Plan Administration for
Due Process Proceedings by attending hearings and appeals meetings
and recording proceedings.
- Tracks monitoring/proctoring documentation necessary for the
granting of special or new privileges to physicians.
- Assists with coordination of collection of information for
additional review for any applicant whose initial or
re-credentialing process reveals factors that may impact on the
quality of care or services delivered to consumers.
- Updates on a daily basis the physician/AHP data base for the
credentials database, and keeps current Medical Staff Services
Department credentialing computer system.
- Follows the CHRISTUS Guidelines related to the Health Insurance
Portability and Protected Health Information ACT (HIPAA), designed
to prevent or detect unauthorized disclosure of Protected Health
- Collaborate with all other departments as appropriate and
required to facilitate the completion of tasks/goals.
- Active participant in health plan’s compliance with the
standards of URAC Credentialing Accreditation.
- Communication, Coordination, Collaboration with all customers,
internal and external.
- Assists Quality Management Department with special
- Serves as liaison to medical staff in matters of credentialing
and related issues.
- Manages projects and timelines to achieve highest quality work
within allotted period.
- Some college or 4-6 years executive secretarial or healthcare
management experience, or prior Medical Staff Coordinator
experience preferably in a hospital or healthcare plan
- Must possess organizational skills necessary to manage the
credentialing office, coordinate activities of the medical staff,
and provide follow-up documentation
- Attention to detail, ability to prioritize, good judgment,
excellent customer service and computer literacy skills a must
- Proficiency in Word Processing and Spreadsheet
- Ability to meet deadlines in high pressure environment
- Able to withstand intense interpersonal interaction
- Confidentiality and compliance with healthcare regulations
affecting special privileges afforded the Medical Staff with
regards to the protected and confidential nature of Medical Staff
- Considerable independent discretionary capacity related to
interpretation and application of state and federal
- Must be able to work independently 80-95% of time.
- Ability to sit for long periods of time.
- Ability to organize and prioritize work to meet deadlines.
- Ability to work occasional long or irregular hours.
- Good speaking ability, judgment, and initiative
- Minimum two years prior experience as a Medical Staff
Coordinator or equivalent position
- Prior experience as Credentialing Coordinator in a health plan
- Certified Professional Medical Staff Credentialing or CPCS
Keywords: Christus Health, Irving , Senior Credentialing Coordinator, Other , Irving, Texas
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