Credentialing Coordinator II, Remote

Trinity Health - Livonia, MI

Full-time - Entry Level

Remote - Livonia, MI

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About the position

This position ensures the timely completion of an application for initial and/or recredentialing by assisting the applicant in submitting all documentation necessary to process the application. The role involves performing a variety of credentialing tasks at the direction of CVO management to complete the credentialing process for Trinity Health RHMs. The individual serves as an RHM liaison throughout the MSOW project phase of new-customer onboarding, and for the 12-months immediately following project completion. This position is an integral part of the credentialing team and is responsible for following credentialing policies and procedures; maintaining an accurate physician database; collecting data; and participating in the development and implementation of changes to the credentialing processes.

Responsibilities

• Assist with the change management associated with the onboarding of new CVO customers.
• Attend CVO project team and data conversion meetings, completing site-specific tasks as needed.
• Serve as a content expert on State-specific regulatory requirements, forms, and processes within an assigned geographic area.
• Provide front-line support to new customers, troubleshooting questions and concerns during the 12-month post go-live period.
• Assist with data validation activities and database clean-up projects following the data conversion process.
• Assist the Manager in the identification and scheduling of reappointment candidates.
• Perform file audits and provide feedback on completed initial and reappointment credentialing files.
• Assist in the training and orientation of new team members.
• Facilitate the integration of new RHMs into the CVO by assisting with data entry and/or data conversion into the physician database.
• Communicate regularly with applicants and the RHMs to complete all requirements of the credentialing criteria within specified timeframes.
• Contact various primary sources to gather the required verifications to complete the background investigation via telephone, fax transmissions, mailings, and Internet to ensure rapid completion of the application.
• Prepare documentation of all verifications including a summary of all verified references for each completed credentials file.
• Assist in the reappointment process; collecting required information, verifying information, and completing appropriate follow-up to complete the reappointment application.
• Meet processing time thresholds consistently and with minimal error.
• Assist with the initial drafting of RHM privilege forms in the PCCB module of the credentialing database.
• Maintain the confidentiality of information acquired pertaining to patient, physicians, employees, and external entities.
• Maintain a customer-focus attitude, good rapport, and cooperative relationships, approaching conflict in a constructive manner.
• Participate in professional development programs and professional organizations to grow in understanding of the various regulations and legislation of the health care industry as appropriate.
• Assume responsibility for performance of job duties in the safest possible manner, reporting all preventable hazards and unsafe practices immediately to management.

Requirements

• Must possess two years of post-high school education, training, or experience; an Associate's degree in health administration or a related field is preferred.
• Two years of work experience in the health care environment and general knowledge of the health care industry including hospital settings, physician practices, and managed care organizations.
• Previous credentialing experience required.
• Knowledge and understanding of NCQA and TJC standards, NPDB guidelines, hospital policies and procedures, and general licensing regulations.
• Knowledge and experience with database organization and management, report generating languages, PCs, and proficiency in Windows-based word processing software.
• Current CPCS and/or CPMSM eligibility by the National Association Medical Staff Services preferred but not required.
• Strong communication skills including the ability to correspond effectively, as well as verbally convey information clearly, listen actively, and consider varying viewpoints when making decisions.
• Strong statistical, analytical and problem-solving skills.
• Ability and desire to provide quality service to others.
• Strong organizational skills and the ability to provide attention to detail and thoroughness.
• Ability to work autonomously and within a team environment.

Nice-to-haves

• Current CPCS and/or CPMSM eligibility by the National Association Medical Staff Services preferred but not required.