Credentialing Coordinator

Credentialing Coordinator

The Credentialing Coordinator helps support the Credentialing team's functions to facilitate onboarding of OrthoIndy medical staff providers with hospital and other facility privileges. The position oversees all OrthoIndy provider credentialing applications and answers any questions regarding provider credentialing. Coordinates all provider initial hospital applications, reappointments, additional privilege requests, and processes them according to the procedures of the various facilities. Assures compliance with established credentialing standards.

Essential Duties:

1. Application processing-advises on and maintains the application process for providers at the facilities in which they intend to treat patients. This may involve OrthoIndy Hospital privileges and external facilities in Central Indiana, as well as provider credentialing on behalf of our OrthoIndiana partners throughout the state. Includes initial applications, reappointments, additional privileges and relinquishments for all associated providers (MD, DO, DPM, NPP, CSFA & CST). Tracks and follows up on application requests and verifications from providers and external facilities.
2. Works with other members of the Credentialing Team and credentialed providers to ensure compliance of all records. Coordinates compliance with maintaining expirable documents within the credentialing files maintained in the credentialing software. Understands the risk of missed documents, and is persistent in following up with providers or other credentialing administrators to maintain the files. Maintains, tracks, and verifies all regulatory data and documentation in accordance with various accrediting bodies.
3. Is knowledgeable of database structure to maintain records within the electronic credentialing system. Supports reporting functions via the medical staff credentialing system. Works with other members of the credentialing office to manage the electronic credentialing software platform.
4. Answers questions, assists with issues that arise and provides detailed information on requirements, processes, and policies. Supports the hospital privilege application process. Communicates with medical staff providers to collect, review, research, and validate facility privilege applications for initial privileges, reappointments, requests for additional privileges to the medical staff for all OrthoIndy employed and non-employed providers. Submits medical staff appointment dues to the Accounting Department for processing.
5. Conducts the monthly and quarterly file audit to ensure compliance with State Board of Health licensure and accreditation program participation. Assists with tracking credentialed providers' licensing and certifications. Notifies providers of upcoming license or certification expirations.
6. Supports Credentialing and Administration teams with Focused Professional Performance Evaluation (FPPE) and Ongoing Professional Performance Evaluation (OPPE) evaluations for all credentialed staff. Maintains compliance by tracking, obtaining and maintaining forms and support documentation per governing body guidelines. Submits all reporting for review to the hospital Medical Executive Committee.
7. Maintains confidentiality of all data, procedures, records, forms, reports, and any other sensitive information.
8. Coordinates, processes and disseminates the executed Affiliation Agreements between universities and OrthoIndy for Clinical University Rotation Program and the timely renewal of contracts.
9. Oversees the implementation of the OrthoIndy's Clinical/ Surgery Observer and University Rotation Program; it's application and approval processes.
10. Provides support to the other team members, as needed; and handles other tasks assigned to the Medical Staff Office team members as needed. Answers questions, assists with issues that arise and provides detailed information on requirements, processes, and policies.

Requirements:

• Bachelor's degree (B.A./B.S.) or equivalent (Preferred), Specialty training beyond high school (e.g., Vocational School) (Required)
• 4-6 years of related experience required, 6-8 years preferred. Progressive experience in healthcare compliance, provider credentialing, or related healthcare operations required in lieu of Bachelor's degree.
• Qualified applicants of the OrthoIndiana divisional practices will be given preference and are encouraged to apply

OrthoIndy is an Equal Opportunity Employer