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Employment Type:

Full time

Shift:

Day Shift

Description:

The Credentialing Coordinator is responsible to oversee the credentialing of new providers and credentialing pertaining to practice changes and new payer contract credentialing and to maintain such credentialing. The incumbent will perform all job functions in a courteous and professional manner consistent with the mission and goals of St Peter’s Health Partners Medical Associates.

Job Duties and Responsibilities

+ Serve as the primary source to ensure verification of all new providers. This includes provider education, licensure, DEA, and National Provider Data Bank

+ Oversee professional staff credentialing files.

+ Secure and maintain primary and excess malpractice coverage and risk management.

+ Credential all new providers according to established regulations and guidelines.

+ Collaborate with the CBO and related staff regarding insurance participation. Assists CBO with claim issues/inquiries potentially relating to credentialing.

+ Coordinate payment of annual medical staff dues and the Medical Society of the State of New York.

+ Ensure annual update of all provider CVs and NP collaborative practice agreements.

+ Create Symed One App file for each new provider.

+ Document policies and procedures for credentialing department including but not limited to instruction manuals.

+ Manage resource budget and present data for additional resources as needed.

+ Stay abreast of current standards and issues by attending conferences, seminars and other related education.

+ Maintain patient and provider confidentiality and adhere to HIPAA regulations as appropriate.

+ Work cooperatively with all team members to ensure quality service at all times.

+ Communicate respectfully and effectively with providers, clinical staff, colleagues, managers and others.

+ Adhere to St Peter’s Health Partner’s Medical Associates employment guidelines at all times.

+ Update Director of Clinical Services at biweekly open issues meetings.

+ Inform appropriate Prime care departments of new provider status.

+ Perform mandatory in-service training. Maintain a clean and safe work environment.

+ Adhere to the St Peter’s Health Partners Medical Associates Code of Conduct in performance of all job duties.

+ Perform other duties as assigned.

_This description is intended to only provide basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve. These responsibilities are subject to change at any time._

Qualifications

+ Associates degree in Business or Healthcare Administrationpreferred

+ High School Diploma required

+ Experience in a healthcare setting interacting with physicians & other providers

+ Strong working knowledge of Microsoft Office applications

+ Effective written & verbal communication skills

+ Demonstrated experience & comfort preparing & delivering presentations

+ Ability to manage multiple projects with tight deadlines simultaneously

+ One to three years of provider credentialing experience preferred

Pay Range: $22.25-$30.75

+ Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran