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Credentialing Coordinator
Credentialing CoordinatorHCA Healthcare • Denver, CO, US
Credentialing Coordinator

Credentialing Coordinator

HCA Healthcare • Denver, CO, US
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Hourly Wage Estimate : $21.93 - $32.88 / hour

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Introduction

Do you want to join an organization that invests in you as a(an) Credentialing Coordinator? At HealthONE Colorado Care Partner, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

HealthONE Colorado Care Partner, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include :

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  • Family support through fertility and family building benefits with Progyny and adoption assistance.
  • Referral services for child, elder and pet care, home and auto repair, event planning and more
  • Consumer discounts through Abenity and Consumer Discounts
  • Retirement readiness, rollover assistance services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  • Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Note : Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Credentialing Coordinator like you to be a part of our team.

Job Summary And Qualifications

DUTIES INCLUDE BUT ARE NOT LIMITED TO :

  • Complete file review for initial and reappointment applications from doctors and advanced practice professionals at the time the application is released from the Credentials Processing Center (CPC). File review includes reviewing the following elements and completing any necessary follow up :
  • Application and HealthONE Addendum Application
  • Privileges
  • Primary Source Verifications (education, training, affiliations, work history, peer references, certifications, licensure, DEA, gaps in time, NPDB, background, etc.)
  • Dynamic credentials (insurance, etc.)
  • CME / CEUs
  • HealthStream Courses
  • Life Support Certifications
  • Immunizations (i.e., PPD, flu)
  • Case logs / activity
  • CV / Resume
  • Supporting documents (i.e., Authorization / Attestation / Release, Confidentiality and Security Agreement, Practitioner Acknowledgement, Pharmacy Signature, etc.)
  • Market forms (HIM electronic signature / edit, MRSA, HealthONE Medical Staff Code of Conduct, Physician Referral Services, APP orientation acknowledgement form, Medical Necessity / Reflex Testing, etc.)
  • Red / Yellow flags
  • CPHP and / or CPEP reports, if required.
  • Aging Provider Assessment for providers 70 and older
  • Build new providers and update existing providers in the Meditech Provider Dictionary for RFCs / RRFCs
  • Build new providers in eSAF and HealthStream / Physician Learning Center
  • Pull case logs / activity reports, if needed
  • Complete data entry in the Cactus database (i.e., as it relates to the Physician Referral Services Form, Health record, etc.)
  • Submit Provider Action Forms as necessary for demographic changes, etc.
  • Review all information received and verify completeness and accuracy on content in accordance with policies and procedures.
  • Communicate with applicants or their practices and HealthONE facilities regarding many facets of credentialing.
  • Sends out reimbursement guide
  • Updates insurance grid
  • Transmit documents to the CPC, Alchemy, and HealthONE based on policy and procedures.
  • Comply with company and department policies / procedures.
  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement."
  • Will be expected to assist the Supervisor and Director with other tasks and projects as requested.
  • KNOWLEDGE, SKILLS & ABILITIES :

  • Maintain working knowledge medical staff credentialing and regulatory requirements.
  • Good working knowledge of general / basic office skills, including computer skills, typing skills, filing, business communications including grammar and spelling skills, basic mathematical calculations, etc.
  • Ability to organize and prioritize efficiently and effectively.
  • Ability to maintain confidentiality of privileged information gained as a result of job functions.
  • Strong interpersonal skills.
  • Excellent teamwork skills.
  • Adept at relationship building.
  • Understand the issues related to credentialing.
  • Ability to adapt to changing company and departmental needs.
  • Proficient in Microsoft Office applications, Internet searches, and relevant data bases.
  • Ability to work independently and under pressure to follow through on issues.
  • Ability to communicate ideas clearly and concisely, in an effective and appropriate manner, both verbally and in writing, with all levels of customers.
  • Ability to establish and maintain long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
  • Ability to work effectively with colleagues, customers, including Medical Staff leaders.
  • High degree of accuracy, timeliness, and attention to detail.
  • EDUCATION

  • High school graduate or GED with college course work in Medical Staff Service Sciences, Business or a related field of study, or an equivalent combination of training and experience.
  • Experience

  • Minimum of two years experience preferred in professional credentialing in a healthcare facility (i.e., Medical Staff Office), managed care setting, or credentials verification organization.
  • CERTIFICATE / LICENSE – Certified Provider Credentialing Specialist or Certified Profession in Medical Service Management preferred.

    PHYSICAL DEMANDS / WORKING CONDITIONS - Requires prolonged sitting, bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires lifting up to 20 pounds occasionally. Work is performed in an office environment. Work may be stressful at times. Contact may involve dealing with angry or upset people.

    We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

    J-18808-Ljbffr

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