Credentialing Coordinator - Medical Staff Office

Overview

University Physicians' Association (UPA) is looking for a skilled Credentialing Coordinator to become a key member of its Medical Staff Office (MSO). This role entails managing the initial credentialing lifecycle for Advanced Practice Providers (APPs) such as Nurse Practitioners, Physician Assistants, CRNAs, Clinical Nurse Specialists, and other credentialed healthcare professionals. The Coordinator will oversee the precise and timely gathering, validation, and examination of credential documents ensuring full compliance with organizational protocols, Joint Commission standards, and relevant state and federal laws.

Key Responsibilities

• Manage the start-to-finish credentialing process for APPs, from receiving applications to final authorization.
• Evaluate application forms for completeness and correctness, identifying omissions and coordinating with applicants when additional information is required.
• Conduct primary source verifications including licensure, education, training, certifications, employment history, references, and malpractice coverage.
• Track progress of credentialing files to meet deadlines and organizational turnaround expectations.
• Serve as liaison between providers, department heads, practice managers, and external agencies regarding credentialing matters.
• Prepare necessary documentation for committee review and approval processes.
• Maintain meticulous credentialing records and databases in electronic formats.
• Ensure adherence to regulatory frameworks such as Joint Commission, NCQA, CMS Conditions of Participation, and pertinent state rules.
• Monitor credential expirations and assist with maintenance of provider credentials over time.
• Generate activity reports and update relevant stakeholders on credentialing status.
• Contribute to initiatives aimed at improving credentialing efficiency and enhancing the onboarding process.
• Protect confidentiality of sensitive provider and institutional information.
• Participate in required committee meetings including Credentials Committee and Advanced Practice Oversight Committee and complete subsequent follow-ups.
• Comply fully with bylaws, policies, and procedures of UPA & UTMC and relevant regulatory requirements.
• Post-training, a hybrid work schedule may be considered based on proven capability to independently execute responsibilities.

Benefits

• Competitive salary packages based on individual skills and experience.
• Extensive benefits comprising medical, dental, and vision insurance plans.
• Generous allotments for paid time off, holidays, and sick leaves.
• 401(k) retirement plan with company matching and immediate vesting.
• Life, disability, and critical illness insurance coverage.
• Supportive culture fostering teamwork, professional growth, and work-life balance.
• A chance to contribute meaningfully within a reputable healthcare institution.

Qualifications

• High school diploma or equivalent credential.
• At least two years of work experience in administrative roles, healthcare, credentialing, medical staff services, or related fields.
• Exceptional organizational skills with a keen eye for detail.
• Capacity to juggle various priorities and adhere to deadlines in a dynamic environment.
• Proficiency in Microsoft Word, Excel, Outlook, and Teams.
• Strong verbal and written communication capabilities.

Preferred Experience

• Prior experience in credentialing, medical staff services, provider enrollment, or healthcare administration preferred.
• Familiarity with credentialing standards and compliance frameworks such as Joint Commission, NCQA, CMS, and state licensing authorities.
• Experience operating credentialing software and managing provider databases.
• Certified Provider Credentialing Specialist (CPCS) designation advantageous or willingness to obtain it.

Knowledge and Skills

• Excellent analytical thinking and problem-solving skills.
• Ability to comprehend and apply credentialing requirements, policies, and regulations.
• Outstanding customer service and relationship management aptitude.
• Independent working capability coupled with strong collaboration in cross-functional teams.
• Meticulous attention to precision and accuracy.
• Ability to maintain confidentiality with professionalism and discretion.