See all roles

Credentialing Coordinator - Full time - REMOTE - (VA,NC, SC, TN, WV, TX, MD )

Work from home Full-time role Hiring

The Credentialing Coordinator is responsible for all aspects of the initial credentialing, re-credentialing and privileging functions for all clinicians on medical and allied health staff at the VCU Health System Hospitals. The Coordinator includes interacting with clinicians to obtain applications and pertinent documents evaluating data for accuracy and completeness, monitoring receipt and follow up responses ensuring timely and efficient processing. This position notifies supervisor Director of any adverse, incomplete or questionable data. This job works independently and is able to assess a situation, consider alternatives and choose the appropriate course of action. This job demonstrates sound organizational ability and effectively sets priorities. This job must be able to maintain strict confidentiality and professional discretion. This job ensures compliance with hospital bylaws, and with local, state and federal requirements. This job provides assistance to the Director in development, plans, organization and control of the operation of the Medical Staff Office in order to meet the mission and goals of the hospital and the requirements of the Medical Staff Bylaws, JCAHO, NCQA Standards and other applicable federal, state and local regulatory and/or accrediting agencies. This job attends medical staff committee meetings as directed. Interacts and provides support services to medical staff officers, departments and chairs as assigned. Licensure, Certification, or Registration Requirements for Hire Certified Provider Credentialing Specialist (CPCS) preferred Licensure, Certification, or Registration Requirements for continued employment Certified Provider Credentialing Specialist (CPCS) preferred Experience REQUIRED Minimum of three (3) years previous credentialing and medical terminology experience in a hospital or managed care credentialing setting Previous experience using a personal computer and various applications, including Microsoft Office Access, Word, and Excel and credentialing software Experience PREFERRED Five (5) years of previous experience in credentialing in a health care environment Previous experience with the application of JCAHO, URAC and NCQA guidelines Certified Professional in Medical Services Management (CPMSM) Education/training REQUIRED Associates or Bachelors degree or experience in lieu. Education/training PREFERREDAssociates or Bachelors Degree in Business, Healthcare or closely related field Independent action(s) required Expresses ideas and exchanges information clearly and concisely. Demonstrates the ability to prioritize work assignments effectively and efficiently within the scope of the employee’s responsibility. Effective development of relationships with other members of the team (i.e. non-clinical personnel, etc.) Highly motivated individual with independent work habits. Organizational skills, proficiency in MS Office Access, Word, and Excel and credentialing software, and numerous hospital databases with extreme attention to detail are critical indicators for success in this role. Ability to multi-task in stressful and limited time constrained environment. Must possess knowledge of local, federal and state laws and regulations and JCAHO standards related to position’s chief objective and demonstrate aptitude for compliance with VCUHS policies, procedures, and customer service philosophy. Supervisory responsibilities (if applicable) N/A Additional position requirements N/A Age Specific groups served N/A Physical Requirements (includes use of assistance devices as appropriate) Physical Lifting 20-50 lbs. Activities Prolonged standing, Frequent bending, Walking (distance), Reaching (overhead, extensive, repetitive) Mental/Sensory Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking Emotional Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Able to adapt to frequent change EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4. Apply To This Job Apply To This Job

You might like

Credentialing Specialist (REMOTE)

Work from home Full-time role

HEDIS Over Reader Nurse – Remote – Contract

Work from home Full-time role

HEDIS Reviewer - RN/LPN/LVN (100% Remote)

Work from home Full-time role

MDS Coordinator – Remote With Local Travel Weekly in Jefferson, IA

Work from home Full-time role

In House Clinical Research Associate- Remote

Work from home Full-time role

Remote Life Insurance Agent Position

Work from home Full-time role

Remote Insurance Sales – Memphis, TN (38109) | Paid Training & Career Growth

Work from home Full-time role

Life Insurance Producer (Remote)

Work from home Full-time role

Medicaid Specialist - SNF

Work from home Full-time role

[Hiring] Government Medicaid- Denial & Follow-up Rep @Ochsner Health

Work from home Full-time role

Remote Environmental Health and Safety Data Analyst

Work from home Full-time role

Experienced Live Chat Customer Service Representative – Remote Opportunity at arenaflex

Work from home Full-time role

[Remote] Valuations Analyst

Work from home Full-time role

Freight Broker (3PL Sales)

Work from home Full-time role

Talent Sourcer

Work from home Full-time role

Sr. Client Services Executive I-Navitus

Work from home Full-time role

Experienced Remote Customer Service Associate – Delivering Exceptional Support from Home

Work from home Full-time role

Customer Success Manager – Renewals

Work from home Full-time role

Experienced Hybrid Commercial Customer Care Professional – Business Banking Services, Account Support & Customer Service Excellence

Work from home Full-time role

Experienced Full Stack Insurance Customer Service Representative – Remote Work Opportunity

Work from home Full-time role