Credentialing Coordinator

Position: CREDENTIALING COORDINATOR
We are an EEO employer, and all hiring practices and other terms and conditions of employment shall be maintained and conducted in a manner that ensures compliance with all applicable federal laws.

Position Summary

This position is responsible for the credentialing and privileging of all HCHN providers.

General Responsibilities

* Maintains credentialing file system in compliance with JCAHO, HCHN policies, DOL and all other governing organizations.

* Handles all aspects of the credentialing process, including updating physicians' applications for credentialing, functions as a liaison between the credentialing organizations and HCHN, and notifying the physicians when their licenses and applications need to be updated.

* Attend training seminars and conferences to maintain knowledge of insurance and HMO requirements.

* Maintain communication between medical staff, patients and insurers.

* Credential and re-credential all physician and mid-level providers according to Health Plan specifications.

* Handles all aspects of the privileging process for providers.

* Maintain accurate, organized, and confidential credentialing and privileging files on all providers.

* Ensure all licensure, certifications, and hospital privileges are current.

* Work independently with providers and Health Plans to research and resolve credentialing-related issues.

* Works conjointly with the providers to ensure CME credits and other trainings are documented.

* Other duties as assigned.