Medical Staff Credentialing Coordinator

Work schedule: Monday-Friday day shift hours Work Type: In-person

What to expect.

Provides administrative and operational support for the credentialing recredentialing and privileging of behavioral health practitioners and clinical staff. Ensures the timely and accurate processing of credentialing applications; maintains practitioner records and credentialing databases; monitors licensure certification and other credential expirations.

Specific responsibilities include:

1. Customer Relations: Actively seeks to provide quality services that meet the needs of clinicians clinical and administrative leadership.
2. Credentialing Appointment & Reappointment Processes:
   1. Coordinate initial and reappointment credentialing applications.
   2. Review credentialing and recredentialing applications for completeness and accuracy.
   3. Obtain and verify required credentials through primary source verifications.
   4. Maintain electronic credentialing files per The Joint Commission (TJC) and State of Maryland requirements.
   5. Prepare appropriate files for Credentialing Committee review.
   6. Maintain ECHO database for all clinicians; generating reports queries letters and lists as needed.
   7. Track expiring licenses certifications and insurances providing timely notices to clinicians and supervisors.
   8. Requests Temporary Privileges per policy.
   9. Requests Expedited Privileging per policy.
   10. Compile State of Maryland updates every six months regarding privileges of physicians.
   11. Participate in accreditation surveys and audits.
   12. Provides updates to Director regarding status of credentialing files for both appointments and reappointments.
3. Managed Care/ Revenue Cycle Support:
   1. Work closely with Managed Care Credentialing Coordinators to ensure completeness of clinician files for pre-delegation and annual delegated payer audits.
   2. Create and maintain ECHO tracking mechanism for use by Managed Care Credentialing Coordinators.
   3. Provide documentation and respond to credentialing inquiries during Managed Care delegated payer audits.

What youll get from us.

At Sheppard Pratt you will work alongside a multi-disciplined team led by a bold vision to change lives. We offer:

• A commitment to professional development including a comprehensive tuition reimbursement program to support ongoing education and licensure and/or certification preparation
• Comprehensive medical dental and vision benefits for benefit eligible positions
• 403b retirement match
• Generous paid-time-off for benefit eligible positions
• Complimentary Employee Assistance Program (EAP)
• Generous mileage reimbursement program

The pay range for this position is $24.0814 minimum to $37.1830 USD maximum. Pay for this position is determined on a number of factors including but not limited to years and level of related experience.

What we need from you.

1. Experience and education required: Requires one of the following education and experience combinations:
   1. Bachelors and 3 years of administrative clerical or office experience in a healthcare environment
   2. Associates and 5 years of experience
   3. HS education and 7 years of experience
2. Experience preferred: Experience or familiarity with behavioral health services preferred
3. Skills and abilities required:
   1. Ability to maintain confidential and sensitive information.
   2. Proficiency in Microsoft Office applications (Excel Outlook Teams and Word).
   3. Strong attention to detail and accuracy in data entry and document management.
   4. Excellent verbal and written communication skills.
   5. Ability to interpret licenses certifications credentialing documents and regulatory requirements.
   6. Strong organizational and time management skills.
   7. Ability to work independently with minimal supervision.
   8. Experience maintaining databases and electronic records.
   9. Ability to maintain a professional demeanor and actively engage in virtual meetings conducted through video conferencing platforms.
   10. Working knowledge of TJC NCQA CARF COMAR and CMS credentialing privileging and regulatory requirements strongly preferred.
   11. Ability to prioritize workload planning for cyclical as well as daily tasks and meeting deadlines.

WHY SHEPPARD PRATT
At Sheppard Pratt we are more than just a workplace. We are a community of healthcare professionals who are dedicated to providing hope and healing to individuals facing lifes challenges. Join us and be a part of a mission that changes lives!

#LI-HD1

Required Experience:

Staff IC