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Title

Credentialing Coordinator 

Category Billing  
Description

The West Valley’s leading cardiology group is expanding and looking to add valuable and skilled team members to our comprehensive and long-standing Practice.

Cardiac Solutions provides a personalized, team-oriented approach to patient care by promoting wellness through education, innovation, and technology. We offer intensive educational opportunities for patients through our disease management clinics and employ a multidisciplinary approach. All team members play a vital role in providing our patients with tailored care and support services. Our focus helps to prevent the progression of heart disease and minimize hospital admissions for our patients.

  • Competitive wages
  • Uniform/Scrub Allowance
  • Monday – Friday for most positions
  • 7 Company Paid Holidays*
  • Employee Medical coverage option as low as $23.00 per paycheck*
  • Dental & Vision*
  • Supplemental coverage options to include Life/AD&D, Short-Term, Long-Term, Critical Illness, Hospital, Accidental*
  • 401(k) retirement plan
  • Paid Time Off*
  • Paid Sick Time
  • Employee Assistance & Discount Programs
  • *Available to full-time, regular employees*    

 

POSITION SUMMARY:

The Credentialing, Licensing & Privileging (CLP) Coordinator is responsible for all aspects of credentialing, to include initial appointment, reappointment, licensing, and privileging for Medical Staff. The CLP Coordinator will process applications, verify information, research application details, and assure processes are followed and in accordance with all State and Federal laws, and Cardiac Solutions and facility standards. The CLP Coordinator will provide consistent, accurate, and timely credentialing, licensing, and privileging support, enhancing the organizations’ ability to provide professional services. Work includes the accurate, timely and documented verification of the information provided by the applicant and maintenance of the highly confidential CLP related files.

ESSENTIAL JOB DUTIES:

  • Prepares and submits all applications and documents for hospital privileges for all medical staff.
  • Prepares documents for submittal to Health Plans to ensure Providers are added to insurance plans.
  • Coordinate credentialing and recredentialing with hospitals medical staff personnel, Physicians and Advance Practice Providers.
  • Ensure all required license and certifications are updated and maintained accurately.
  • Communicates with state agencies to verify current licensure and board certification.
  • Contact Providers as necessary to maintain current and accurate information within CAQH Providers credentialing files.
  • Maintain all records related to credentialing, privileging, and licensing for all medical staff and insurance contracts.
  • Maintains all records related to DEA certification and recertification.
  • Responsible for ensuring malpractice coverage is updated and maintained.
  • Responsible for communicating with hospital medical staff personnel, licensing agencies and insurance companies.
  • Serves as a resource to other staff members in reference to credentialing, licensing, and privileging for all insurance plans.
  • Update and maintain online directory for contracted insurance carrier to ensure accurate demographics and practice locations.
  • Maintain appropriate insurance contracts for government and commercial insurances.
  • Maintain a working knowledge of applicable Federal, State, Local laws, and regulations, including the Standards of Conduct, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behaviors.
  • Adhere to the confidentiality policy.
 
Position Requirements

KNOWLEDGE, SKILLS AND ABILITIES:

  • Knowledge of Microsoft Office products.
  • Knowledge of credentialing, licensing, privileging Process for Medical Staff.
  • Knowledge of insurance contracts.
  • Knowledge of HIPAA regulations.
  • Ability to work in a fast paced-environment and work well under pressure.
  • Ability to maintain confidentiality and professionalism.
  • Ability to display sense of urgency while remaining organized.
  • Ability to work effectively and efficiently in an independent manner.
  • Skill in working with Physicians, Advance Practice Providers, and other Medical and non-medical staff members.
  • Skill in communicating with insurance carriers.
  • Skill in communicating with Hospital Facilities.

 

EDUCATION AND/OR EXPERIENCE:

  • Two to three years of recent credentialing, licensing, privileging and medical experience.
  • Detail oriented.
  • Experience with the use of credentialing software preferred.
  • Excellent customer service skills.
  • Excellent verbal and written communication skills.
  • Excellent analytical and organizational skills.

 

PHYSICAL DEMANDS/WORK ENVIRONMENT:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the following physical/work environment functions apply:

  • Sit for extend periods of time, stand, talk, bend or hear
  • Type, utilizing a computer keyboard
  • May lift to 15 lbs.
  • Utilize a multi-line telephone system
 
Full-Time/Part-Time Full-Time  
Shift Days  
Minimum Education  
Travel Requirements  
Exempt/Non-Exempt Non-Exempt  
Location Peoria Office  
About the Organization Cardiac Solutions is a medical, physician-owned business that provides a comprehensive range of cardiac health services to the general public and referred patients. Founded in 1984 by Dr. Joseph Caplan, our clinics have established a solid reputation for innovative cardiology treatments and personalized cardiovascular care. We are proud of our status as the West Valley's leading cardiology team, specializing in YOUR total heart care. Our board-certified cardiologists always put your treatment and care first, allowing you to have the peace of mind knowing that your heart is in good hands.

With our intensive educational opportunities through nurse-directed clinics, we help prevent the progression of heart disease by offering extensive cardiology testing. Our main goal is to avoid hospital admissions by accurately diagnosing and treating cardiac problems at the earliest possible stage. During this process, you not only build a relationship with your physician, but with the many members of our TEAM, all of whom are focused on YOUR heart health.  
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.  

This position is currently not accepting applications.

To search for an open position, please go to http://JOSEPHACAPLANMDPCdbaCardiacSolutions.appone.com



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