Job: Credentialing Coordinator - Physician Practices - Full-Time - Days

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Job Description

Northwest Medical Center is a 300-bed hospital offering a full range of healthcare services including emergency services, accredited chest pain and heart failure programs, neurology and neurosurgery, outpatient imaging, a nationally accredited surgical weight loss program, total joint program, spine program and stroke center (recognized with Gold Seal designations by The Joint Commission), robotic surgery, GI lab, a free-standing women’s center, inpatient rehabilitation facility, wound care center, five urgent care facilities, and three ambulatory surgery centers. NMC also has several affiliated physician practices including Northwest Allied Physicians offering primary care and a wide range of specialists, Desert Cardiology of Tucson, Heart Center of Southern Arizona and Northwest Heart & Vascular. NMC is accredited by The Joint Commission and is an equal opportunity employer: race, gender, disability and Veteran status, and VEVRAA Federal Contractor - priority referral Protected Veterans requested.

Summary:  Performs diversified duties of considerable responsibility to support the Medical Staff and Hospital Departments.        


Essential Functions:

1. Maintain physician credentialing files and data bases for managed care credentialing process for employed physicians.       

2. Ensure physician licensure, DEA certifications, medical malpractice, and Board Certification is maintained.      

3. Collect, complete, coordinate and submit all credentialing application materials including signatures for hospitals and managed care agencies in required time frame for both the initial and re-credentialing process.      

4. Collect, complete, coordinate and submit all documentation to Corporate for enrollment into various managed care plans.      

5. Obtain Medical Liability Coverage through Corporate for applicable employed physicians. Process termination paperwork for Medical Liability Coverage through coverage in a timely manner.      

6. Collaborate provider related information with Practice Management Team members.       

7. Maintain CAQH data base for applicable Allied Physicians/Providers.      

8. Report required changes to licensure agencies (addresses, physician supervision).      

9. Facilitate critical requests to process timely applications for managed care.        

10. Manage and prioritize projects.    



Qualifications

Education:  High School diploma/GED preferred or equivalent years of experience required.      

Experience:  Three (3) years experience in medical staff credentialing.      

Skills:  Type 60 WPM; ability to work independently and under pressure with attention to detail; telephones, statistics; compose letters/ memorandums; computer literacy; data entry, retrieval, reporting; proofread; research information; adding machine; calculator; fax; personal computer/word processor; copy machine.      

Licenses/Certifications :  Preferred: CPCS/CMSC NAMSS Certification    

 

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