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External Applicant Current Associate

Coordinator Credentialing Senior Job in Shreveport

Job Description

SUMMARY

Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process within the CVO.  Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. Responsible for the accuracy and integrity within the credentialing database.

MAJOR RESPONSIBILITIES 

• Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility. 
• Conducts thorough investigation, research, and timely primary source verification of all components of the application file. 
• Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up. 
• Reviews necessary documentation and verifications prior to submittal to clients, ensuring turnaround time and quality of data is within required metrics. 
• Responds to inquiries from other healthcare organizations, interfaces with internal/ external customers on day-to-day credentialing/privileging issues as they arise. 
• Utilizes and maintains the credentialing database, optimizing efficiency, and performs queries, reports, and document generation. 
• Meets weekly performance metrics which includes:  file completion, quality, and turnaround time.   
• Trains new associates on job responsibilities, and provides further re-education. 
• Leads projects assigned by management. 
• Maintains strict confidentiality of all data and information. 
• Performs miscellaneous job-related duties as assigned. 

POSITION QUALIFICATIONS 

• Bachelor’s Degree or equivalent job-related experience 
• Minimum of at least five (5) years’ experience related to hospital or managed care credentialing. 
• Certified Provider Credentialing Specialist (CPCS) preferred. 

Work Type: 

Full Time