Credentialing Coordinator, Health Sciences Deans Office

University of Delaware

Equal Employment Opportunity Statement

The University of Delaware is an Equal Opportunity Employer which encourages applications from Minority Group Members, Women, Individuals with Disabilities and Veterans. The University's Notice of Non-Discrimination can be found at http://www.udel.edu/aboutus/legalnotices.html


Job No: 497146
Work Type: Staff
Location: Newark
Categories: Health Services, Full Time


PAY GRADE: 29N

CONTEXT OF THE JOB:

Under the general direction of the Clinical Operating Officer, the Credentialing Coordinator is responsible for coordinating all functions related to the credentialing and re-credentialing of all health care clinics and providers. In addition, this position coordinates the clinical staff and providers credentialing with all medical payors, handles visas for credentialed providers, and maintains provider credentialing files. The Credentialing Coordinator interprets operating and university policies; exercises independent judgment in resolution of credentialing issues. The Credentialing Coordinator must be cognizant of the requirements and nuances of each payers? specific application process to avoid unnecessary delays in the provider enrollment process. The Credentialing Coordinator must be well organized, accurate, detailed oriented and have strong interpersonal skills.

RESPONSIBILITIES:

• Receive and process all initial credentialing and re-credentialing applications.
• Collect all pertinent information from the provider, provider's malpractice insurer and other sources as deemed appropriate.
• Ensure that credentialing, re-credentialing, delegations of providers occur on a timely basis in accordance with industry and University standards and criteria.
• Assist in tracking of insurance contracts.
• Maintain accurate and complete records of each application's status.
• Maintain a status on all active credentialing and/or re-credentialing applications.
• Maintain all credentialing and re-credentialing timelines and schedules.
• Maintain strict level of confidentiality on all matters pertaining to provider.
• Ensure continuous verbal and written communication with providers and managers on where they stand in the credentialing process.
• Maintain well-organized provider files that are easily reviewed by credentialing committees, outside review bodies, and others.
• Ensure that the master spreadsheet is factually correct and up to date daily.
• Process approval, denial, or termination letters on behalf of UD Health as needed.
• Work closely with the Revenue Cycle Manager to assist with preparation of reports and other duties.
• Track competencies, licenses, and required training.
• Perform other administrative duties as assigned by management.

QUALIFICATIONS:

• High school diploma or GED and three to five years of credentialing experience, or equivalent combination of education and experience. Associate's degree preferred.
• Ability to manage priorities and workflow.
• Strong organizational, problem solving and analytical skills.
• Proven ability to multi-task.
• Attention to detail, flexible and willingness to work in a fast-paced environment.
• Excellent written and oral communication skills.
• Demonstrates ability to plan and organize projects.
• Proficient with MS Office and other software applications.
• Ability to work collaboratively with multiple health professionals in a busy and complex environment using tact, diplomacy, and discipline.
• Ability to work independently and as a member of various teams and committees.
• Demonstrates an understanding and consideration of the differing needs and concerns of individuals with varying identities, cultures and backgrounds.
• Committed to fostering a workplace culture of belonging, where diversity is celebrated and equity is a core value.

Notice of Non-Discrimination, Equal Opportunity and Affirmative Action
The University of Delaware does not discriminate against any person on the basis of race, color, national origin, sex, gender identity or expression, sexual orientation, genetic information, marital status, disability, religion, age, veteran status or any other characteristic protected by applicable law in its employment, educational programs and activities, admissions policies, and scholarship and loan programs as required by Title IX of the Educational Amendments of 1972, the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, Title VII of the Civil Rights Act of 1964, and other applicable statutes and University policies. The University of Delaware also prohibits unlawful harassment including sexual harassment and sexual violence.

Applications close:

PI152985919