Credentialing Coordinator
Trinity Health
**Employment Type:**
Full time
**Shift:**
Day Shift
**Description:**
+ Process credentialing forms/applications for new and existing Holy Cross Medical Group physicians accurately and in a timely manner.
+ Monitors/tracks status of credentialing information via hard copy and computerized program, and performs appropriate follow-up.
+ Assures the accuracy of the status of Medical Group physicians in relation to participation in Medicare, Medicaid, and managed care plans.
+ Establish and implement systems to adhere all credentialing criteria of Medicare, Medicaid, and managed care plans.
+ Proofreads applications and backup material for accuracy before submission to Medicare, Medicaid, and managed care plans.
+ Records are organized and easily available for review.
+ Maintains file copies of applications/recredentialing material sent back to insurance plan for each HCMG physician.
+ Works closely with the Medical Staff Team.
+ Participate in all audits and CAPS with payers to ensure delegated credentialing.
+ Works with MSOW software.
+ Works with Sympler and keeps it updated.
+ Verifies all education and training.
+ Obtains professional references.
+ Verifies all licenses/certifications.
+ Contacts appropriate Department Chief for review of all material.
+ All information is presented in a timely manner to appropriate committees.
Minimum Qualifications:
+ High school graduate or equivalent required.
+ EPIC experience highly preferred
+ Three to five years' experience in a healthcare environment or a Medical Staff Office.
+ Proficient in Microsoft Word and Excel.
+ Ability to perform with little or no supervision.
+ Familiar with Medical Terminology.
+ Strong organizational skills and attention to detail.
+ Ability to communicate effectively.
**Our Commitment to Diversity and Inclusion**
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran
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