Physician & APP Credentialing Coordinator; Remote

Overview

Department: 38144 Enterprise Corporate - Physician Recruitment

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Schedule Details/Additional Information: Fully remote, Monday-Friday

Pay Range
: $25.30 - $37.95

• Evaluates requests for applications and obtains authorization as needed. Determines appropriate action to accept or deny application requests. Initiates application process.
• Processes applications, reappointments and other credentialing events to the Medical Staff/Network, assessing practitioner information to determine the presence of potentially adverse information and determines further action required. Responsible for quality control on the content and completeness of finalized practitioner credentials files.
• Coordinates biennial review, ensuring each practitioner seeking reappointment is evaluated according to requirements by external accreditation and regulatory standards.
• Documents all work performed for credentialing events in database as part of the communication with internal customers.
• Communicates the progress, completion and findings of ongoing applications to leadership, and as appropriate to other customers. Identifies evolving issues of concern and takes appropriate action.
• Maintains credentialing database according to department policies and procedures and regulatory guidelines. Provides an electronic historical record of credentialing events within the organization.
• Responsible for investigation and documentation of practitioner credentials, utilizing specialized knowledge to obtain verification of all aspects of a practitioner's background, training and past practice. Understands credentialing requirements of both The Joint Commission and NCQA, CMS and other governmental requirements, and performs in accordance with these standards.
• Generates and maintains accurate documentation that may be reviewed and judged for acceptability by state and federal licensing agencies, external customers and may be called into a court of law to justify decision-making by Aurora entities. Manages external audits for delegated credentialing contracts, prepares and reviews files, transmits to delegate, demonstrates adherence to NCQA standards through individual credentialing records.
• Evaluates privilege requests to ensure that required supporting documentation named in privilege criteria is included.
• Deals with customer questions and complaints by Aurora Health Care caregivers, physicians, allied health practitioners and external agencies.

• None Required.

• High School Graduate.

• Typically requires 3 years of experience in a related field such as physician credentialing, medical education, or medical staff office in a healthcare environment.

• Strong customer and physician relations skills.
• Excellent organizational and communication skills.
• Proficient in the use of Microsoft Office (Excel, Access, PowerPoint and Word) or similar products.
• Ability to work effectively with minimal supervision and manage multiple priorities.
• Knowledge of basic medical terminology (department specific).

• Must be able to sit, stand, walk, lift, squat, bend, twist, crawl, kneel, climb and reach above shoulders at various times in each workday. Must be able to file in a five-drawer filing cabinet.
• Must be able to use hands with fine manipulation when using computer keyboard.
• Must be able to occasionally lift up to 30 lbs.
• Must have functional vision, speech, and hearing.
• Exposed to a normal office environment.
• Operates all equipment necessary to perform the job.