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Job TitleCredentialing Coordinator
LocationCleveland
FacilityRemote Location
DepartmentCRP Medical Staff Services-Cleveland Clinic Martin Health
Job Code001006
ShiftDays
Schedule8:00am-4:30pm
Job Summary
Job Details
*Remote in FL, OH, NV*
Credentialing Coordinator
Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.
As a Credentialing Coordinator, you will coordinate all aspects of credentialing, verification and the development and maintenance of systems and procedures within the Credentialing Office to ensure timely, thorough and accurate credentials verification. The caregiver in this role ensures that Cleveland Clinic is in compliance with State, National, JCAHO, NCQA and URAC credentialing requirements.
A caregiver in this position works 8:00am – 4:30pm.
A caregiver who excels in this role will:
Coordinate the appointment and reappointment process for all CCF professional caregivers, medical caregivers and Advanced Practice Providers.
Meet credentialing/re-credentialing deadlines.
Maintain and track professional license renewals.
Coordinate and process all applications for reappointment in a timely manner as required by TJC and NCQA.
Review and process all requests for temporary and on-case privileges to physicians.
Assist in maintaining peer review files for all physician and advanced practice providers credentialing files in an organized and consistent manner.
Assist with all components of the preliminary primary source verification process.
Develop and maintain effective lines of communication necessary for CCF's day to day credentialing operations.
Obtain credentialing information on all new CCF medical staff members.
Inform OPSA, Department/Division Chairs and Legal of highly sensitive, sometimes adverse, information uncovered in the credentialing/re-credentialing process.
Adhere to credentialing timeframes and deadlines dictated by regulatory bodies so that provider files stay in compliance at all times.
Assist the Manager in file review for annual audits by Manage Care Plans.
Develop and implement ways in which to improve and more efficiently accomplish compliance per NCQA per the delegated plans.
Assist with the departmental orientation of new medical staff members, including maintaining and updating physician orientations packets.
Prepare and email all applications for privileges and follow-up phone calls to doctor offices to expedite credentialing.
Perform all quarterly license and monthly OIG/Medicare Sanctions and EPLS required checks.
Maintain physician acknowledgment statements to meet FMQAI requirements.
Track and maintain all license, DEA, malpractice insurance, and board certification expiration dates.
Update revised and current delineation of privilege forms for physician.
Assist with annual staff meeting preparation.
Distribute, collect, and tabulate all medical staff voting items.
Maintain all demographic information on all medical staff rosters.
Maintain complete and up-to-date documentation and files
Assist the Manager in the development and fulfillment of short/long term departmental goals.
Minimum qualifications for the ideal future caregiver include:
High school diploma or GED.
Three years of experience coordinating and developing office systems and procedures including two years in a medical staff office performing credentialing functions.
Knowledge of all aspects of medical staff services work.
Advanced knowledge of credentialing functions and systems.
Working knowledge of licensure requirements in Florida.
Thorough knowledge of current credentialing standards of TJC, NCQA, URAC and reporting criteria for the National Practitioner Data Bank.
Preferred qualifications for the ideal future caregiver include:
Certified Professional Credentialing Specialist (CPCS) and/or Certified Professional Medical Services Management (CPMSM) certification preferred or willingness to obtain certification.
Credentialing experience.
Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/
Physical Requirements:
Ability to perform work in a stationary position for extended periodsAbility to operate a computer and other office and laboratory equipmentAbility to travel throughout the hospital systemAbility to communicate and exchange accurate information.Personal Protective Equipment:
Follows standard precautions using personal protective equipment.
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for controlled substances and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the Equal Employment Opportunity poster.
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities