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Credentialing Coordinator
Trinity Health. Ensure timely completion of initial and recredentialing applications by assisting applicants with required documentation .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in credentialing processes, including data management, verification, and compliance with healthcare regulations. Strong organizational and communication skills are essential for managing multiple tasks and ensuring timely completion of credentialing applications.
Highest-signal resume keywords
Credentialing Process ManagementKnowledge of NCQA and TJC StandardsDatabase Organization and ManagementStrong Communication SkillsStatistical and Analytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CredentialingData EntryFile AuditsVerification DocumentationReport Generating Languages
Soft Skills
Organizational SkillsAttention to DetailProblem-Solving SkillsAbility to Work AutonomouslyFlexibility
Tools & Technologies
PCCB Credentialing Database ModuleWindows-Based Word Processing Software
Certifications & Qualifications
CPCS EligibilityCPMSM Eligibility
Industry Keywords
Healthcare EnvironmentManaged Care OrganizationsHospital Policies and ProceduresLicensing RegulationsCompliance Programs
About the role
Key responsibilities & impact- Ensure timely completion of initial and recredentialing applications by assisting applicants with required documentation
- Perform credentialing tasks under CVO management direction for Trinity Health RHMs
- Follow credentialing policies and procedures and maintain an accurate physician database
- Collect data and participate in credentialing process changes
- Assist with identifying and scheduling reappointment candidates
- Perform file audits and provide feedback on credentialing files
- Assist with training and orientation of new team members
- Perform daily data entry and facilitate new RHM data integration or conversion
- Communicate with applicants and RHMs to complete credentialing requirements within specified timeframes
- Contact primary sources by telephone, fax, mail, and Internet to obtain verifications
- Prepare verification documentation and summaries of verified references
- Assist with reappointment applications, including information collection, verification, and follow-up
- Meet processing time thresholds with minimal errors
- Assist with drafting RHM privilege forms in the PCCB credentialing database module
- Maintain confidentiality of patient, physician, employee, visitor, and hospital information
- Track errors and complaints to support process improvement
- Perform other duties assigned by the Director
- Maintain knowledge of applicable laws, regulations, compliance programs, and policies
- Follow safety practices and report hazards
Requirements
What you’ll need- Must possess two years of post-high school education, training, or experience
- One year of work experience in the health care environment
- General knowledge of the health care industry, including hospital settings, physician practices, and managed care organizations
- Knowledge and understanding of NCQA and TJC standards, NPDB guidelines, hospital policies and procedures, and general licensing regulations
- Knowledge and experience with database organization and management, report generating languages, PCs, and Windows-based word processing software
- Strong communication skills
- Strong statistical, analytical, and problem-solving skills
- Strong organizational skills and attention to detail and thoroughness
- Ability to work autonomously and within a team environment
- Must comply with Trinity Health policies and procedures
- Ability to organize work priorities, adapt to frequently changing priorities, and work on multiple tasks/projects
- Ability to complete work during high-pressure periods while maintaining flexibility and a pleasant attitude
- Current CPCS and/or CPMSM eligibility preferred but not required
Benefits
Comp & perks- Equal Opportunity Employer commitment
- Professional development programs and participation in professional organizations