Credentialing Coordinator II (Eastern United States resident)

Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: No Job Summary: Plans, coordinates, and oversees procedures and processes of the Provider Credentialing Program in compliance with regulatory requirements. Ensures compliance with all credentialing and privileging requirements of applicable regulatory agencies. Conducts background investigations on physicians and other providers applying for affiliation including licensure, education and post-graduate clinical training, board certification, disciplinary actions and other professional sanctions, malpractice history, and peer assessment of current competence at time of appointment, reappointment, and cross credentialing. Job Duties: Preferred experience in Echo or Credential Stream Reviews and analyzes physician applications and credentialing documents including certificates of education, residency and fellowship training, board certification and eligibility, licensure, professional work history, liability insurance and malpractice history. Assesses completeness of information and providers' qualifications relative to established standards. Reviews and analyzes primary source verification for licensure, certification or registration required to practice a profession. Requests, maintains, and ensures competency data is present at appointment and re-appointment. Maintains tracking of all new providers drug screening, background checks, child abuse clearance, finger printing, code of conduct, disruptive practitioner policies, current clinical competency data and Health Service information for new providers. Maintains a working knowledge of applicable regulatory agencies. Immediately reports to manager any collected information which may be averse to an applicant. Identifies and flags adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for credentialing revi