Credentialing Coordinator - Full Time

Grady Health System Atlanta , GA 30301

Posted 3 weeks ago

Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady!

SUMMARY

The Credentialing Coordinator is responsible for all aspects of initial credentialing/privileging and recredentialing/privileging of physicians and advanced practice providers who perform patient care services at Grady Health System. The Credentialing Coordinator independently gathers, conducts and analyzes data/information via the primary source in accordance with the credentialing/privileging standards of all applicable accrediting and regulatory agencies (TJC, NCQA, State, and Federal) as well as the Grady Health System Medical Staff Bylaws and Rules and Regulations and Grady Health System policies and procedures. Performs the initial and re-credentialing of Grady employed providers with all managed care plans and third-party payors through delegated processes in accordance with standards of the Grady Health System policies and procedures, Medical Staff Bylaws, and Grady Managed Care contracts

QUALIFICATIONS

  • Associate's Degree in Healthcare Administration (or related field) OR 7+ years of relative experience in a healthcare office setting may be considered in lieu of education required

  • Bachelor's Degree in Healthcare Administration (or related field) Preferred

  • Must possess and maintain a working knowledge of The Joint Commission, NCQA and state/federal accrediting agencies requirements/standards regarding credentialing/privileging.Three years of credentialing/privileging experience in a hospital or managed care setting and/or Medical Staff Services, Two years of database experience OR

  • Three years minimum in progressively responsible positions in a complex business/administrative office setting, which includes working with physicians, advanced practice providers or other professional groups six (6) or more years of job related experience including 2 years in a leadership role.

  • Excellent verbal and written communication skills, ability to interact with all levels of personnel

  • Strong organizational, ability to multi-task and prioritization as demonstrated by the successful and timely completion of assignments

  • Keen attention to detail, conflict resolution skills, self-starter; flexible

  • Superior knowledge of Microsoft applications

  • Certified Provider Credentialing Specialist (CPCS) or CPCS within two years of meeting qualifications to take certification exam, or time specified by the Director of Medical Staff Services.

Equal Opportunity Employer-Minorities/Females/Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity.


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Credentialing Coordinator - Full Time

Grady Health System