Previous Job
Previous
Credentials Evaluation Coordinator
Ref No.: 18-14213
Location: Walnut Creek, California
POSITION PURPOSE:

Assures that work in process files have had queries to verification entities completed in accordance with the requirements set forth in the Credentialing Operations Manual. Perform final analysis of departmental work products to assure that potentially adverse information is red flagged and that the final work product meets requirements described in the Credentialing Operations Manual.


REPORTING RELATIONSHIP:
  • Reports to the Manager, Consolidated Credentialing Department.
  • No subordinates report to this position.

ESSENTIAL FUNCTIONS:
  1. Assures that data entry of required source verification data elements and hardcopy practitioner master files are managed in accordance with procedures as outlined in the Consolidated Credentialing Operations Manual.
  1. Assesses practitioner files to determine the presence or absence of potentially adverse information in accordance with established guidelines. Summarizes the results of the assessment in the file audit summary report.
  1. Responsible for quality control on the content and completeness of completed practitioner credentials files.
  1. Maintains lines of communication on work products and evolving issues of concern with regard to applicants/reapplicants with credentials assistant, other site managers and CCD manager.
  1. Prepares completed practitioner credentials file for delivery to off-site medical staff office managers.
 
  1. Advises the Manager, Consolidated Credentialing Department of outstanding issues requiring management intervention.
 
  1. Back-up Credentials Intake Coordinator during absence and peak processing periods.


NON-ESSENTIAL FUNCTIONS:

The following non-essential job functions are listed to inform you of significant duties and/or skills that form some of the basis for evaluation for merit increases of employees in this position. This does not exclude consideration of applicants who do not possess the ability to perform those skills or duties upon application.
  • None currently.

SPECIALIZED REQUIREMENTS:
  • Must have formal college education in a related field such as Nursing, or Medical Records or Health Care Administration.
  • Significant relevant experience (three to five years) may substitute for a formal degree. This must be in a related field such as in physician credentialing, medical education, a hospital environment or health insurance.
  • Previous experience processing Medical Staff applications required. Previous Executive Assistant experience or Certification as a Medical Coordinator preferred.
  • Proven track record of effective physician relations skills necessary.
  • Excellent organizational and communication skills required.
  • Must have word processing skills. Previous experience with personal computers preferred.

MENTAL/PHYSICAL REQUIREMENTS:
  • Must be able to sit, stand, walk, lift, squat, bend, twist, crawl, kneel, climb and reach above shoulders at various times in each workday.
  • Must be able to use hands with fine manipulation when using computer keyboard.
  • Must be able to occasionally lift up to 10 lbs.
  • Must have functional vision, speech, and hearing.
  • Exposed to a normal office environment.
  • Operates all equipment necessary to perform the job.