Credentialing Coordinator

Position Summary / Career Interest:

Coordinates the credentialing and onboarding of physicians and allied health providers for professional staff membership and hospital privileges. Provides administrative support for medical staff functions including credentialing applications and files, bylaws and policies and committee support. Serves as a resource for regulatory requirements for CMS, The Joint Commission and NCQA for delegated credentialing standards.

Responsibilities:

• Demonstrates competence in the areas of critical thinking, interpersonal relationships, and technical skills.
• Demonstrates ability to provide care/service safely and efficiently for the care of each patient.                               
• Coordinates gathering of primary source documentation for new hospital employed applicants (medical staff and allied health personnel) to present to Credentials Committee as directed by Director, Medical Staff Affairs. 
• Coordinates gathering of primary source documentation for new applicants (medical staff and allied health personnel) to present to Credentials Committee as directed by Director, Medical Staff Affairs.
• Assists Director in implementing processes to adhere to regulatory requirements relating to credentialing.
• Verify compliance with CMS guidelines by checking OIG and GSA Monthly Reports against Medical Staff members to determine if any sanctions have been issued.
• Verify monthly actions by Kansas State Board of Healing Arts and comparing to Medical Staff members to determine if any sanctions have been issued.
• Processes all NPDB reports for initial, reappointments and when additional privileges are requested.
• Notifies appropriate personnel of new provider numbers as well as reporting those individuals who have resigned and relinquished staff status at University of Kansas Hospital. 
• Assists with various organizational activities, including preparation of audits and reports as directed.
• Attends meetings and takes minutes as assigned
• Supervise Credentialing Specialist, working to cross-train in credentialing process and obtaining Medicare/Medicaid provider numbers. 
• Maintains credentials files, filing information as received.Supports office mission for service by receiving and screening calls for colleagues in their absence.

*Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

*Note: These statements are intended to describe the essential function and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Job Requirements

Required:

• High School Diploma

Preferred:

• Associates' degree in Business
• CPCS
• CPMSM

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.

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