Kaiser Permanente - Washington Permanente Medical Group
Renton, Washington
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The Credentialing Coordinator works at the direction of the Director of Medical Staff Services. This position performs credentialing and recredentialing for the purpose of Medical and Advance Practice Clinician membership and privileging in accordance with the Medical Staff Bylaws, Rules & Regulations, Policy and Procedure, and in alignment with appropriate regulatory agencies (e.g. DNV, The Joint Commission, NCQA, CMS, etc.)
The Medical Staff Credentialing Coordinator manages practitioner files, working cooperatively with practitioners, internal departments, and contract groups ensuring the seamless and timely flow of credentials information in order to meet credentialing deadlines.
Responsibilities:
Coordinates Medical/APC Staff credentialing (initial, reappointment applications, temporary privileges and requests for additional privileges) from receipt to approval
Collects and analyzes documents, data and verifications and prepares reports by monitoring data published by regulatory agencies and boards, OIG, NPDB and other applicable sources, screening for any adverse actions
Collaborates with practitioners and/or contract and practice group contacts regarding status of applications, credentialing issues, pending expirations or expirations of required licensure and certifications, or questions related to credentialing and to ensure timely credentialing
Coordinate with healthcare providers, insurance companies, and regulatory agencies to resolve discrepancies
Maintains and updates provider databases and files with current documentation
Prepare reports and assist in audits to support organizational compliance.
Ensure compliance with state, federal, and accrediting body regulations - DNV, NCQA, Joint Commission, CMS CoPs, NM state statutes
Assists with special projects as assigned
Requirements:
Education:
High School diploma or equivalent required.
Associate or Bachelor degree in related field preferred, or equivalent work history.
Experience:
Two or more years? experience in health care environment working directly with physicians, advanced practice professionals, and office staff demonstrating the ability to complete assigned tasks independently or with minimum supervision.
Credentialing or Medical Staff experience desired.
Above average verbal and written communication skills to promote excellent customer relations, with ability to transmit and receive information accurately
Strong reading and writing skills in English
Strong organizational and analytical skills
Strong understanding of technology with ability to learn new software programs including database and cloud-based services
Ability to work in stressful situations and perform multiple tasks simultaneously
Ability to work collaboratively
Must have critical thinking skills to execute the detailed job functions
Certifications, Registrations, or Licenses:
Current Certified Provider Credentialing Specialist (CPCS) through the National Association Medical Staff Services (NAMSS) or must become certified within twenty-four (24) months after date of hire.
CHRISTUS Health is an international faith-based, not-for-profit health care system based in Irving, Texas, with more than 60 hospitals in Texas, Louisiana, New Mexico, Chile, Colombia and Mexico. CHRISTUS Health is made up of 50,000 Associates providing compassionate and individualized care at more than 600 centers, including community hospitals, clinics, long-term care facilities and health ministries. Sponsored by the Sisters of Charity of the Incarnate Word of Houston, Sisters of Charity of the Incarnate Word of San Antonio and the Sisters of the Holy Family of Nazareth, our mission is to extend the healing ministry of Jesus Christ to every individual we serve.