Credentialing Coordinator (UTHP ADM Patient Account)

Job Summary:

Under general supervision, the Credentialing Coordinator is responsible for assuring the proper credentialing and privileging of physicians, mid-level Providers, research associates, professionals, and paraprofessional individuals. The Credentialing Coordinator will maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications for each Provider. The Credentialing Coordinator also tracks and ensures the completion of required continuing medical education courses/workshops.

Job Duties:

1. Guide Provider through credentialing and re-credentialing process and ensure the completion of required documentation for UT Health and all facilities where the Provider delivers services. Works with Provider to prepare and submit Medicare & Medicaid applications to enrollment office.
2. Prepare all credentialing applications, develop, and provide documentation that are not supplied by the Provider, address any additional information or corrections requested.
3. Verify and track the proper credentialing and re-credentialing of physicians, professionals, and paraprofessional individuals within UT Health and all facilities where the Provider has privileges.
4. Receive credentialing application and enter data into credentialing system.
5. Work with Provider to maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications for each Provider, generate monthly report of expiring credentials.
6. Ensure ongoing monitoring of performance between credentialing cycles, generate performance review documentation, share with department for completion, and notify external entities when a Provider has been suspended, if necessary.
7. Work with Departments to obtain proof of Professional Liability coverage.
8. May provide support and information needed for monthly credentialing committee meetings, provide report to the committee of initial and reappointments.
9. Notify Providers and departments of credentialing status and final result, email notice to department and provider, ensure credentialing system (currently MD Staff) is updated with final credentialing result.
10. Ensure UT Health website accurately reflects Provider’s credentials once cleared.
11. Track and ensure the completion of required continuing medical education courses/workshops; provide documentation to outside entities according to requirements.
12. Conduct customer service tasks such as responding to Provider, applicants, administrators, and hospital inquiries, provide documents to physicians/office staff seeking copies.
13. Perform all other duties as assigned.

Education:

Associate's degree is required.

Experience:

Three (3) years administrative experience, preferably in the hospital or clinical field, is required.

Licenses and Certifications:

Supervisory Requirements:

• None.