Company: Acacia Network
Posted on: September 25, 2022
Credentialing Coordinator Bronx, NY : 4/13/2022
Under the supervision of the Credentialing Manager, the
Credentialing Coordinator will organize and maintain all aspects of
the credentialing process and functions related to the
Credentialing Department. The responsibilities of this position,
include but are not limited to, tasks that are related to the
initial credentialing and recredentialing of Other Licensed
Certified Practitioners (OLCP) and Other Clinical Staff (OCS). The
Coordinator will arrange document collection, verifications, and
file maintenance for his/her category of providers. The Coordinator
is responsible for analyzing and evaluating credentials and
maintaining files in accordance with organizational policy,
accreditation requirements and regulatory standards. The
Coordinator ensures the appropriateness and accuracy of each
document in credentialing file, database and Excel
KEY ESSENTIAL FUNCTIONS:
+ Maintain communication with Human Resources (HR), practitioners
and program leaders to coordinate the receipt of information
required for credentialing, recredentialing, status changes,
terminations and expiring credentials for OLCP and Other Clinical
+ Perform thorough review and analysis of provider applications,
accompanying documents and files for new and existing
+ Identify discrepancies and resolve them quickly, ensuring
credentialing compliance, including but not limited to, missing,
incomplete, or differing information on documents (i.e., resume,
+ Continuously evaluate file elements to determine if additional
information is needed and follow up as appropriate to resolve.
+ Identify issues that require additional investigation and
evaluation such as validating discrepancies, adverse reports,
negative reviews or ratings, and undisclosed matters that arise
through the process. Ensure that those issues are brought up for
review and discussion with the Credentialing Manager
+ Perform relevant primary source verifications including, but not
limited to, licensure, registrations, certifications, affiliations,
malpractice, National Practitioner Data Bank (NPDB), Office of
Inspector General (OIG), Office of Medicaid Inspector General
(OMIG) and other agencies as delineated by credentialing
+ Perform timely data entry and upkeep of provider information in
the credentialing database, related spreadsheets and credentialing
+ Monitor OLCP and clinical staff training per regulatory agency
(tracking, notifications, pursuit and storage).
+ Perform internal audits of credentialing files and resolves
non-compliance components by pursuing missing elements and
correcting erroneous documents.
+ Assist in all external audits, i.e., Human Resource Services
Administration (HRSA), Office of Alcohol and Substance Abuse
Services (OASAS), The Joint Commission (TJC), Office of Mental
Hygiene (OMH) and Department of Health (DOH) and managed care
companies. This will include preparing and scanning files; updating
audit rosters and obtaining missing items from providers and
+ Work collaboratively with Human Resources and department leaders
on day-to-day credentialing and privileging issues as they
+ Participate in all regulatory, accreditation and managed care
audits involving credentialed providers.
+ Provide timely responses to data requests.
+ Coordinate and collaborate with peers towards systematic efforts
to maintain data integrity.
+ Recommend and initiate ideas for process improvement.
+ All other duties as assigned by Credentialing Manager or
designee, as it pertains to credentialing.
REQUIREMENTS (Qualifications, Skills and Competencies):
+ High School Diploma/GED required. Associates degree
+ Minimum of one (1) years of experience in a Human Resources or
Credentialing Department capacity in a healthcare environment, with
knowledge of onboarding functions, procedures and processes.
+ Proficient in Microsoft Office suite (i.e., Outlook, Excel, Word
and Power Point).
+ Type 25wpm.
+ Must display efficiency in compliance management, document
management, on/off boarding management, and privileging management,
possessing the following knowledge, skills and attributes to
fulfill credentialing goals:
+ Extreme attention to detail;
+ Agility to manage conflicting priorities;
+ Ability to deduce which priority is most important amongst
+ Process mindset: approach problems, develop solutions, make
suggestions for improvements;
+ Takes initiative and asks questions;
+ Capacity to organize and structure work load;
+ Capability to handle a large volume of emails on daily basis;
+ Ability to follow through and complete an activity or process
that has been started.
+ Excellent verbal and written communication skills digitally or in
*Acacia Network is an equal opportunity employer*
Keywords: Acacia Network, New Rochelle , Credentialing Coordinator, Other , Bronx, New York
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