Credentialing Coordinator III

Department: Credentialing
Brentwood, TN or Hybrid

Position Summary

Local candidates can expect a hybrid work schedule.

In addition to being responsible for all aspects of onboarding locums and maintaining providers on hospital rosters, the Credentialing Coordinator II works closely with the supervisor/lead to ensure team’s success serving as a subject matter expert, assisting with training, and participating in special projects.  Works with the assigned Credentialing Specialist and Provider Enrollment to facilitate timely, successful onboarding of the provider and maintenance of existing providers. This individual leads by example ensuring adherence to Standard Operating Procedures and company policies.

Primary Duties and Responsibilities:

  • 15%: Processes and submits applications timely for reappointment of privileges in accordance with the hospital and corporate requirements.
  • 15%: Follows up with providers on expirables from 45-days to due date to ensure timely renewal and escalates concerns to leadership ensuring providers follow federal, state and hospital requirements; updates APP credentialing files and hospital partner files with current credentialing documents.
  • 10%: Serve as a subject matter expert for activities related to onboarding, reappointments, expirables and assist with training new team members and remedial training.
  • 10%: Conduct primary source verifications during the reappointment phase to ensure providers continue to meet APP standards and escalates any red flags as per the SOP.
  • 10%: Ensures timely reissue of COI through completion of the insurance application for all assigned providers.
  • 10%: Onboards locum providers to include collecting required documents, conducting required verifications, and entering data in Credentialing system.
  • 10%: Audits rosters throughout the year ensuring that credentialing and scheduling databases matches the current hospital rosters.
  • 10%: All other duties as assigned to include special projects as needed to support department initiatives.
  • 5%: Escalate concerns regarding the processing of providers and non-response to management.
  • 5%: Processes term status changes for both facility only and total term.

Knowledge/Education & Experience Required:

  • High school diploma or equivalent required
  • At least 3 years of healthcare industry experience
  • Customer service and/or administrative experience preferred
  • Associates degree preferred

Skills Required:

  • Basic computer and keyboarding skills required
  • Strong verbal and written communication skills required
  • Research and analyze data to support decision making
  • Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources

Abilities Required:

  • Ability to handle and maintain secure files containing sensitive personal information
  • Ability to organize and prioritize work and manage multiple priorities
  • Ability to work independently with minimal supervision
  • Ability to establish and maintain effective working relationships with providers, management, staff and contacts outside the organization
  • Ability to follow established work-flows; standard operating procedures and corporate policies and procedures
  • Ability to work independently and in a team environment
  • Ability to serve as company representative

Physical Demands/Requirements:

  • Continuously sitting
  • Frequent walking, standing, bending, kneeling, and reaching
  • Continuous repetitive use of arms, hands and fingers
  • Occasional lifting and carrying up to 20 pounds

Mental Demands/Requirements:

  • High level of mental awareness
  • High level of attention to detail

Apply for this Position

Note: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

*INTERNAL CANDIDATES: To be considered for an open position, you must be in good standing (i.e., not on a Performance Improvement Plan) and in your current position for at least six months. You must also meet the minimum requirements for the job and be able to perform the essential functions of the position.

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