Coordinator Credentialing Senior Job in Shreveport
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.
- 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.
- 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.