Coordinator, System Credentialing

Join to apply for the Coordinator, System Credentialing role at St. Joseph's/Candler

• The Credentialing Coordinator adheres to industry and SJ/C established credentialing guidelines and completes in-depth review and analytics of provider applications and accompanying documents to successfully facilitate the process of ensuring provider meets the requirements of SJ/C, Network and Medical Staff for initial, recredentialing, demographic and other elements of provider credentialing delivering the highest level of accuracy, timeliness and effectiveness of the credentialing and enrollment process.
• Verifies competence, medical and professional education, residency, internships, fellowships, additional training, board certifications, healthcare affiliations, work history, military experience, professional references, licensure and certifications, DEA and Controlled Substance as applicable, malpractice coverage and privileges the applicant is requesting.
• Completes all plan enrollment for applicable providers as well as maintaining a detailed status report throughout the process tracking the credentialing and enrollment to ensure exceptional communication internally and externally.
• Compiles all information for credentialing committee meetings coordinating through the Manager of Credentialing and Network Services and Director of Managed Care and Market Relations. Prepares and submits all reports to Administration timely for inclusion in the Board of Trustee report.
• Maintains a working knowledge of Hospital, Network and Medical Staff Bylaws and Policies and Procedures as they related to the provider credentialing and enrollment process.
• Provider applications are distributed and processed in a compliant manner. Files are presented to Credentialing Committee and/or Chairperson or action in a timely manner and provider notification letters are distributed within one week of approval.

• Bachelor’s in Healthcare or Business – Preferred
• 3-5 Years healthcare experience – Required
• Credentialing experience and medical terminology – Preferred
• Knowledge of Joint Commission, NCQA and AMA credentialing standards – Preferred
• License & Certification: NAMSS, AAPC or Institute for Credentialing Excellence Certification as a Credentialing Specialist or Credentialing Coordinator – Preferred. Must be successfully attained within 12‑month of entering the position and successfully maintained annually.

Mid‑Senior level

Full‑time

Information Technology

Hospitals and Health Care