Credentialing Coordinator (medical staff)

PRIMARY FUNCTION:
The Credentialing Coordinator's primary function is the credentialing and re-credentialing of healthcare providers. This role ensures that all Physicians, NPs, PAs, and CRNAs meet regulatory, accreditation, and healthcare standards to safeguard patient care. The coordinator partners with the Medical Staff, APPs, Department Managers, and all hospital employees to maintain these standards.

RESPONSIBILITIES AND ACCOUNTABILITIES

• Maintains confidential, organized credential files on all members of the medical staff, and APPs including current staff status, current licensures and other certifications and current clinical privileges in accordance with TJC, CMS and state regulations of the LSBME
• Manages and maintains provider credentialing and re-credentialing process and files
• Coordinates the credentialing appointment and reappointment processes and obtains necessary data for each applicant by sending applications and other required documents to practitioners in a timely manner

• Maintains accurate and up-to-date credentialing records and databases
• Facilitate the credentialing process by actively communicating with providers to secure required information and documentation.
• Prepare and submit credential applications and supporting materials to Credentials Committee and Medical Executive Committee
• Monitor expiring credentials and facilitate timely renewals
• Resolve credentialing discrepancies and respond to inquiries
• Coordinate internal and external audits related to credentialing
• Stay informed about changes in healthcare laws and credentialing standards
• Responsible for attendance, preparation, presentation of credentialing files, meeting agenda and minutes for the Credentialing Committee
• Preparation of meeting agendas and formal minutes for the MEC (Medical Executive Committee), and the Medical Staff Committee
• Oversee all catering and meeting room preparations for the Medical Staff Committee, ensuring meal orders are placed one week in advance and the space is fully prepared for attendees
• Provides reminders to Committee members the morning of the meetings and possibly the days prior
• Provide current updates to the Director of Quality of any concerns or questions related to credentialing files or meetings
• Will meet with the Director of Quality the week prior to the Credentials Committee to review all files prepared for the meeting
• Perform additional duties and responsibilities as required to support departmental objectives

JOB SKILLS AND KNOWLEDGE

• High School diploma or equivalent
• Competent in word, excel and power point
• Certified Provider Credentialing Specialist (CPCS) certification (preferred)
• Minimum of 3 years of experience in medical credentialing in a hospital
• Experience with credentialing software systems
• Strong understanding of Joint Commission, NAMSS, LSBME, and other regulatory standards
• Excellent organizational and communication skills
• Ability to manage multiple tasks and meet deadlines

Equal Employment Opportunity Statement