Credentialing Coordinator, Medical Staff Office First Shift

Job Description

Performs credentialing duties and collaborates with physician offices, hospital medical staff committees, and the UC Health Central Verification Office to complete data collection and documentation for the medical staff and allied health professionals in the credentialing process. Responds to requests for verification and information from internal and external customers. Coordinates and prepares documents for Credentials Committee and other medical staff committees as assigned.

Maintains the physician credential/privilege database and files.

Credentialing and Privileging Administration

• Assembles, compiles, and presents documentation to support the accurate and timely initial appointment and reappointment of Medical Staff and Advanced Practice Providers.
• Collects and verifies information from internal and external sources.
• Ensures compliance with organizational, accreditation, and regulatory requirements.
• Identifies potential credentialing issues and proactively assists in their resolution.

Database and File Management

• Creates, maintains, and updates provider credentialing files and databases to ensure accurate, complete, and compliant records.
• Maintains physician and provider information in Cactus and other applicable systems.
• Tracks TB and other health status records as required.
• Generates reports for internal and external customers.
• Conducts quality reviews of records to ensure data integrity and compliance.

Customer Service and Communication

• Serves as a resource for medical staff and credentialing-related inquiries.
• Collaborates with the Central Verification Office, physician offices, Patient Care Services, Medical Staff leadership, and Hospital Administration.
• Responds to requests in a timely and professional manner.
• Identifies issues and works proactively toward effective resolution.

Committee Support

• Provides administrative support for Medical Staff and Allied Health committees.
• Prepares meeting agendas, rosters, and supporting materials.
• Records and distributes meeting minutes and summaries.
• Maintains committee documentation and records.
• Prepares timely and accurate reports for the Medical Executive Committee and other leadership groups as assigned.
• Assists with the orientation of new physician members serving on credentialing committees.

Medical Staff Office Operations

• Assists in maintaining an organized and efficient Medical Staff Office.
• Provides oversight, training, and performance support for credentialing specialists, clerical staff, volunteers, and other support personnel as assigned.
• Maintains compliance with departmental policies and procedures.
• Assists the Director with business operations, performance improvement initiatives, accreditation readiness activities, and special projects.

Other Duties

• Performs other duties and responsibilities as assigned.

Preferred Qualifications:

• Bachelor's degree preferred.
• CPCS (Certified Provider Credentialing Specialist) and/or CPMSM (Certified Professional Medical Services Management) certification through the National Association of Medical Staff Services (NAMSS) preferred.
• One (1) to three (3) years of physician credentialing experience with knowledge of medical staff accreditation standards required.
• Experience in a hospital, physician group, or managed care credentialing environment preferred.
• One (1) to two (2) years of hospital-based credentialing experience preferred.