Coordinator, Credentialing

at  DaVita

5200 Virginia Way, Brentwood, Tennessee, 37027, United States of America
Reports to Manager Physician Credentialing and Peer Review. Performs daily functions of the credentialing and recredentialing process by processing applications for Physicians, Renal Fellows, and Non-Physician Practitioners. Credentials providers according to all Credentialing Policies and Procedures, Medical Staff Bylaws, and Federal and State regulatory requirements. Works with various departments and clinic personnel as a resource and to ensure timely credentialing.

MINIMUM QUALIFICATIONS:

• Associates or Bachelor’s degree preferred
• CPCS certification preferred
• 2-4 years related credentialing experience and/or training: or equivalent combination of education and experience.
• Previous credentialing experience highly preferred
• Ability to positively interact with practitioners, practitioner office groups, and other internal and external contacts
• Excellent computer skills including Excel, Word, Database maintenance, and Internet use. Knowledge of MSOW credentialing software a plus.
• Deals with confidential information and/or issues using discretion and judgment

• Reports to the Credentialing Services Manager and performs all day-to-day activities related to the credentialing and recredentialing of facility providers
• Responsible for processing a high volume of privilege requests from: Physicians, Renal Fellows, Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists
• Review and track requests to add/remove practitioners to facilities in assigned states
• Reviews and manages practitioner files for content and completeness and to identify potentially adverse information in accordance with guidelines established by the Medical Staff Bylaws.
• Generates and tracks primary source verifications for credentialing process as required by appropriate regulatory bodies and the Medical Staff Bylaws.
• Communicating with practitioners regarding credentialing status, providing updates and obtaining additional information as required
• Assures the integrity of information and verification source data when performing the data entry into the credentialing software for collection and maintenance of an accurate practitioner database.
• Organize and distribute information needed for committee meetings and for facilitating governing body votes. Maintain confidential files on all providers.
• Scan documentation of approved membership/privileges and privilege letters and ensure timely notification is sent to practitioners
• Follow up on all outstanding vote requests and provide ongoing expirables maintenance
• Serve as liaison between Credentialing Department and facilities to assist with education of and compliance with Medical Staff Bylaws