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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, compliance with NCQA and TJC standards, and effective communication with applicants and healthcare professionals. Proven ability to maintain confidentiality and support process improvements while managing multiple tasks in a fast-paced environment.
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 EntryData ConversionReport Generating LanguagesDatabase Management
Soft Skills
Organizational SkillsProblem-Solving SkillsAttention to DetailAbility to Work AutonomouslyAbility to Provide Quality Service
Tools & Technologies
PCCB Credentialing Database ModuleWindows-Based Word Processing Software
Certifications & Qualifications
CPCS EligibilityCPMSM Eligibility
Industry Keywords
Health Care EnvironmentHospital SettingsPhysician PracticesManaged Care OrganizationsLicensing Regulations
About the role
Key responsibilities & impact- Ensure timely completion of initial and recredentialing applications by assisting applicants with required documentation
- Perform credentialing tasks under the direction of CVO management for Trinity Health RHMs
- Follow credentialing policies and procedures and maintain an accurate physician database
- Collect data and participate in developing and implementing credentialing process changes
- Assist the Manager with identifying and scheduling reappointment candidates
- Audit files and provide feedback on completed initial and reappointment credentialing files
- Assist with training and orientation of new team members
- Perform daily data entry and data conversion for new RHMs
- Communicate with applicants and RHMs to complete credentialing requirements within specified timeframes
- Contact primary sources by telephone, fax, mail, and Internet to obtain verifications for background investigations
- Prepare verification documentation and summaries of verified references
- Assist with reappointment applications by collecting, verifying, and following up on required information
- Meet processing time thresholds consistently with minimal error
- Assist with drafting RHM privilege forms in the PCCB credentialing database module
- Maintain confidentiality of patient, physician, employee, visitor, and external-entity information
- Track errors and complaints to support process improvement
- Identify problems, offer solutions, and participate in resolution
- Maintain knowledge of applicable laws, regulations, compliance programs, policies, and procedures
- Perform other duties assigned by the Director
Requirements
What you’ll need- Must possess two years of post-high school education, training, or experience
- Associate degree in health administration or a related field preferred
- 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
- Knowledge of report generating languages, PCs, and Windows-based word processing software
- Current CPCS and/or CPMSM eligibility preferred but not required
- Strong communication skills
- Strong statistical, analytical, and problem-solving skills
- Ability to provide quality service to others
- Strong organizational skills and attention to detail and thoroughness
- Ability to work autonomously and within a team environment
- Ability to comply with Trinity Health policies and procedures
- Ability to organize work priorities, adapt to frequent changes, and work concurrently on multiple tasks/projects
- Ability to complete work during high-pressure periods while maintaining flexibility and a pleasant attitude
Benefits
Comp & perks- Professional development programs
- Participation in professional organizations
- Equal opportunity employment