Back to all jobs

Credentialing Coordinator - Full time - REMOTE - (VA,NC, SC, TN, WV, TX, MD )

Work from home Full-time role Hiring

The Credentialing Coordinator is responsible for all aspects of the initial credentialing, re-credentialing and privileging functions for all clinicians on medical and allied health staff at the VCU Health System Hospitals. The Coordinator includes interacting with clinicians to obtain applications and pertinent documents evaluating data for accuracy and completeness, monitoring receipt and follow up responses ensuring timely and efficient processing. This position notifies supervisor Director of any adverse, incomplete or questionable data. This job works independently and is able to assess a situation, consider alternatives and choose the appropriate course of action. This job demonstrates sound organizational ability and effectively sets priorities. This job must be able to maintain strict confidentiality and professional discretion. This job ensures compliance with hospital bylaws, and with local, state and federal requirements. This job provides assistance to the Director in development, plans, organization and control of the operation of the Medical Staff Office in order to meet the mission and goals of the hospital and the requirements of the Medical Staff Bylaws, JCAHO, NCQA Standards and other applicable federal, state and local regulatory and/or accrediting agencies. This job attends medical staff committee meetings as directed. Interacts and provides support services to medical staff officers, departments and chairs as assigned. Licensure, Certification, or Registration Requirements for Hire Certified Provider Credentialing Specialist (CPCS) preferred Licensure, Certification, or Registration Requirements for continued employment Certified Provider Credentialing Specialist (CPCS) preferred Experience REQUIRED Minimum of three (3) years previous credentialing and medical terminology experience in a hospital or managed care credentialing setting Previous experience using a personal computer and various applications, including Microsoft Office Access, Word, and Excel and credentialing software Experience PREFERRED Five (5) years of previous experience in credentialing in a health care environment Previous experience with the application of JCAHO, URAC and NCQA guidelines Certified Professional in Medical Services Management (CPMSM) Education/training REQUIRED Associates or Bachelors degree or experience in lieu. Education/training PREFERREDAssociates or Bachelors Degree in Business, Healthcare or closely related field Independent action(s) required Expresses ideas and exchanges information clearly and concisely. Demonstrates the ability to prioritize work assignments effectively and efficiently within the scope of the employee’s responsibility. Effective development of relationships with other members of the team (i.e. non-clinical personnel, etc.) Highly motivated individual with independent work habits. Organizational skills, proficiency in MS Office Access, Word, and Excel and credentialing software, and numerous hospital databases with extreme attention to detail are critical indicators for success in this role. Ability to multi-task in stressful and limited time constrained environment. Must possess knowledge of local, federal and state laws and regulations and JCAHO standards related to position’s chief objective and demonstrate aptitude for compliance with VCUHS policies, procedures, and customer service philosophy. Supervisory responsibilities (if applicable) N/A Additional position requirements N/A Age Specific groups served N/A Physical Requirements (includes use of assistance devices as appropriate) Physical Lifting 20-50 lbs. Activities Prolonged standing, Frequent bending, Walking (distance), Reaching (overhead, extensive, repetitive) Mental/Sensory Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking Emotional Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Able to adapt to frequent change EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4. Apply To This Job Apply To This Job

More remote roles to explore

Credentialing Specialist at SnapCare

Work from home Full-time role

Career Opportunities: Credentialing Specialist - Remote Must Reside in North Carolina (267595)

Work from home Full-time role

Medical Biller / Insurance Verification Representative (Remote)

Work from home Full-time role

Insurance Verification and Patient Support Specialist (Remote in AZ, ID, NV, OR, UT, WA)

Work from home Full-time role

Insurance Verifications Specialist (Remote)

Work from home Full-time role

Insurance Verification Specialist I

Work from home Full-time role

Admissions & Collections Clerk - Insurance Verification/QA

Work from home Full-time role

HEDIS Over Reader Nurse – Remote – Contract

Work from home Full-time role

HEDIS Reviewer - RN/LPN/LVN (100% Remote)

Work from home Full-time role

HEDIS Abstractor - Nurse

Work from home Full-time role

Experienced Customer Service Professional – Remote Opportunity with arenaflex

Work from home Full-time role

Social Community Growth Manager GCC

Work from home Full-time role

Part-Time Data Entry Coordinator, Program Impact – Join arenaflex in Revolutionizing Upward Mobility for First-Generation College Grads

Work from home Full-time role

Mgr Financial Clearance - REMOTE

Work from home Full-time role

Experienced Part-Time Remote Customer Service Representative – Amazon E-commerce and Technology Innovation

Work from home Full-time role

Life & Retirement Advocate II

Work from home Full-time role

Experienced Data Entry Specialist - Remote Opportunity at arenaflex

Work from home Full-time role

Entry Level Freight Dispatcher – Work from Home – $1,200 to $3,000+/Week (1099)

Work from home Full-time role

Director, Development

Work from home Full-time role

Remote ABA Billing Specialist(must have ABA Billing experience)

Work from home Full-time role