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Credentialing Coordinator
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Overview
Facilitate the credentialing and re-credentialing of eligible population across all D-H H system members.
Responsibilities
- Process the credentialing and re-credentialing, including the validation of identity, training, experience, reputation and competence of applicants applying or re-applying for membership.
- Provides communication regarding the credentialing and re-credentialing process and requirements.
- Obtains missing information and clarifies any inconsistencies identified between submitted documentation and verifications.
- Ensures timely completion of credentialing and re-credentialing applications.
- Ensures that the credentialing/re-credentialing programs maintain compliance with regulatory standards (e.g. TJC, NCQA and CMS, etc.), internal policies and D-H Professional Staff Bylaws, Rules and Regulations.
- Conducts quality assurance reviews on credentialing and re-credentialing files.
- Enters new data, maintain existing records, and assists in the continued development of the comprehensive credentialing database.
- Provides support to system members regarding education and training around the Credentialing process.
- Performs other duties as required or assigned.
Qualifications
- High school diploma or equivalent with 3 years of experience in healthcare or Human Resources.
- Associates degree in business or healthcare related field preferred.
- Strong written and verbal interpersonal skills required.
- Must be detail oriented.
- Demonstrated proficiency in word processing, spreadsheet software, database management and data entry preferred.
Required Licensure/Certifications
- None
