The University of Rochester is hiring a Credentialing Coordinator IV to play a key role in our Medical Staff Services. You will ensure the quality of our credentialing, privileging, and primary source verification processes, directly contributing to the quality of practitioners and patient safety at our facility.
What You'll Do
- Determine practitioner eligibility for membership and participation.
- Analyze applications for accuracy and completeness, and inform practitioners of their status.
- Obtain, research, and evaluate information from primary sources to ensure compliance with accreditation and regulatory standards.
- Conduct thorough background investigations and primary source verification for all application components.
- Recognize, investigate, and validate discrepancies and adverse information discovered during the application process.
- Process privilege requests, ensuring compliance with clinical privilege description criteria.
- Monitor the initial and reappointment process for all Medical and Allied Health Professional staff to ensure timely processing.
- Track the status of files in departmental and committee review until final approval.
- Monitor personal performance statistics and communicate with managers regarding questions or concerns.
- Collaborate with Credentialing Managers, staff, various departments, and key stakeholders to ensure policies and standards are met.
- Communicate file status directly to providers, department representatives, clients, and affiliates.
- Communicate expiring credential status to providers and coordinate efforts to obtain necessary information.
- Serve as a resource on medical staff bylaws, policies, and procedures for departments and clients.
- Respond to inquiries from other healthcare organizations and interface with internal and external customers on credentialing issues.
- Collaborate with management to review and assess departmental functions to identify areas for improvement.
- Assist with various aspects of the credentialing expirable process.
- Represent the Medical Staff Services Department on various initiatives and committees as needed.
- Serve as back up to other credentialing staff and act as a Team Peer Interviewer as needed.
What We're Looking For
- An Associate's degree in business or a healthcare related field and 2 years of medical administrative experience.
- An equivalent combination of education and experience.
- Fluent English language skills, both oral and written.
- Proficiency in MS Office (Word, Excel, PowerPoint), email, and internet.
Nice to Have
- 1 year of medical credentialing and/or payer enrollment experience.
- Knowledge of and experience with Joint Commission, CMS, and NCQA Regulations related to medical staff services and Commercial Payers Credentialing.
- Knowledge of and experience with database applications.
- Exceptional interpersonal and communication skills.
- Ability to develop and maintain relationships with a variety of key stakeholders.
- Certified Medical Professional Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) credential upon hire.
Technical Stack
- MS Office (Word, Excel, PowerPoint)
- Email and Internet
- Database applications
Team & Environment
You will collaborate closely with Credentialing Managers and staff, as well as various departments and key stakeholders across the organization.
Benefits & Compensation
- Compensation Range: $23.06 - $32.29 per hour.
- University of Rochester culture is built on Equity, Leadership, Integrity, Openness, Respect, Accountability and an inclusive, welcoming environment.
Work Mode
This is an onsite position located at 135 Corporate Woods, Rochester, New York, 14623.
The University of Rochester is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law.
