Credentialing Coordinator

It's more than a career, it's a calling.

WI-SSM Health St. Mary's Hospital - Madison

Worker Type:

Regular

Job Highlights:

This is a full time day shift Credentialing Coordinator position for SSM St. Mary's Hospital located in Madison, WI. Ideal candidates are detail oriented, organized, and have excellent written and verbal communication skills. The key duties in this position include accepting, reviewing, and approving credentialing applications. The work schedule for this role is Monday through Friday, 7:00 a.m. to 3:30 p.m. or 8:00 a.m. to 4:30 p.m., employee preference.

Job Summary:

Coordinates the credentialing process relating to the credentialing services provided by the organization.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Reviews all new applications, determines qualifications for staff membership, evaluates completeness of application, and process file including primary source verifications or may assign to appropriate credentialing specialist based on work activity.
• Oversees the processing of reappointment applications for medical staff and allied health professional staff, ensuring completeness within specified timeline.
• Maintains credentialing database, audits data periodically to ensure accuracy, and serves as super-user for troubleshooting and training users.
• May process pre-applications and send out new application requests.
• May interact with physicians, physician office staff, personnel and center staff for required documents.
• May provide direction and serve as a resource to credentialing specialists on the initial credentialing process. May problem solve when difficulties arise during the process. May serve as a resource to staff for any difficulties that arise during the expirable process ensuring all licensure, credentialing and insurance are current.
• May process requests for additional clinical privileges, medical staff status changes, and resignations.
• May meet with credentials chairman prior to monthly committee meeting, may review all new applications scheduled for presentation to ensure completeness and accuracy of physician profile, and may obtain any additional information as needed.
• May coordinate monthly credentials committee meeting; may develop agenda, prepare packets for review, notify members, and maintain meeting minutes. May follow up on any actions identified by the committee, may prepare necessary correspondence to applicants and update credentialing database as needed.
• May assist with credentialing audits from payers or regulatory agencies.
• Performs other duties as assigned.

EDUCATION

• High School diploma/GED or 10 years of work experience

EXPERIENCE

• Two years' office experience in healthcare or medical environment

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, s