Credentialing Coordinator

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🕒 June 10

🗽 New York – Remote

🗽 New York – Remote

💵 $23 - $32 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

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UR Ventures

WebsiteLinkedInAll Job Openings

11 - 50 employees

📚 Education

🤝 B2B

🔬 Science

Education • B2B • Science

UR Ventures is the innovation and commercialization arm of the University of Rochester, focused on advancing research and academic entrepreneurship. It connects university faculty and researchers with industry partners to facilitate the development of new technologies and businesses that can positively impact society. UR Ventures promotes collaboration, creativity, and knowledge transfer, thereby contributing to the university's mission of making the world ever better.

📋 Description

• Participates in departmental activities to ensure quality in conducting, maintaining, and communicating the medical and allied health professional staff credentialing, privileging, and primary source verification process. • Serves as a resource of the department, and collaborates with other team members to advance the quality of practitioners and patient safety of the facility. • Determines practitioner eligibility for membership/participation. • Analyzes application and supporting documents for accuracy and completeness and informs the practitioner of the application status, including the need for any additional information or corrections. • Obtains, researches, and evaluates information from primary sources to ensure compliance with accreditation and regulatory standards to validate the accuracy of applications for one or more decision making bodies. • Recognizes, investigates, and validates discrepancies and adverse information obtained during the application process to ensure review and approval bodies have information needed to make informed credentialing decisions. • Processes requests for privileges when applicable, ensuring compliance with criteria outlined in clinical privilege descriptions. • Monitors the initial and reappointment process for all Medical and Allied Health Professional staff as needed to ensure appointments are processed in the requested or required timeframes and meet regulatory requirements. • Monitors the status of completed files in departmental review and/or committee review until final approval to ensure compliance with regulatory standards. • Monitors personal performance statistics related to accuracy and productivity and communicates with the managers when questions or concerns arise or when additional training is needed. • Reviews performance measures and goals with auditors and management regularly. • Collaborates and coordinates activities with the Credentialing Managers and staff. • Collaborates with various departments and key stakeholders to ensure all policies and standards are met. • Communicates the status of applicant files directly to providers and various department representatives, clients, and/or affiliates. • Serves as a resource for departments and clients pertaining to medical staff bylaw, policies, and procedures.

🎯 Requirements

• Associate's degree in business or healthcare related field and 2 years of medical administrative experience required • 1 year of medical credentialing and/or payer enrollment experience preferred • Fluent English language skills (oral and written) required • Proficiency in MS Office (e.g. Word, Excel, and PowerPoint), email, internet required • Knowledge of and experience with Joint Commission, CMS, and NCQA Regulations related to medical staff services and Commercial Payers Credentialing preferred • Knowledge of and experience with database applications preferred • Exceptional interpersonal and communication skills preferred • Ability to develop and maintain relationships with a variety of key stakeholders across the organization preferred