Credentialing Coordinator
About Us
Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings.
Our Mission
As CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all. To learn more about a calling that defines and unites, please click here for more information about our mission, vision, and values.
The posted compensation range of $24.33 - $36.19 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
Job Summary:
Coordinates credentialing activities; including data entry and physician database maintenance; credentialing processes, reappointment credentialing, expirables and other duties that support provider on-boarding activities. Serves as effective liaison between the provider and the facility throughout the credentialing process. Responsible for understanding State and Federal Regulatory Agencies requirements, accreditation compliance, and other critical matters that affect the healthcare environment. Performs other duties as assigned in an effective competent manner.
Essential Function:
- Maintains up-to-date physician database of all applications, enrollment status, demographics, medical licenses, drug enforcement administration certificates, professional liability insurance, etc.
- Responsible for the accuracy and integrity of data entered into the credentialing database system.
- Assist in designing/compiling other data supporting various statistics utilized internally to monitor operations.
- Responsible for continuous collection of information required to comply with delegated agreements and credentialing policies.
- Conducts credentialing database training for new hires, and refresher training for existing staff. Provides input for training materials and job aids.
- Reviews applications and other data sources for accuracy and completeness prior to submitting to Health Plan.
- Acts as liaison with Health Plan representatives regarding individual credentialing applications; audits; provider load confirmation; fee schedule load issues; and addressing potential corrective action plans and monitoring for a successful resolution.
- Maintains relationships with office personnel, Legal, Regulatory and Health Plan's Provider Relations department to provide and/or obtain documentation pertinent to timely and accurate completion of the delegated credentialing process.
**Candidates must currently reside in Arizona
Job Requirements
Minimum
High School Diploma/GED.
Three (3) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment.
Preferred
- Bachelors degree preferred
Certified Professional Medical Services Management (CPMSM) and/or Certified Provider Credentialing Specialist (CPCS) Certification preferred.
Knowledge, Skills and Training:
- Proficient with CACTUS Software, or similar credentialing system Intermediate Microsoft programs skills (MS Word, Excel, Power Point).
- Knowledge of NCQA standards and Joint Commission standards.
- Knowledge of commonly-used concepts, practices, and procedures used in health care and physician credentialing.
Where You'll Work
Located conveniently in the heart of Phoenix, Arizona,St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of Mercy, St. Joseph's was the first hospital in the Phoenix area. More than 125 years later, St. Joseph's remains dedicated to its mission of caring for the poor and underserved.
We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought-after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from outside of Arizona and the United States to seek treatment at St. Joseph’s.
U.S News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with Phoenix Children's Hospital.
St. Joseph's is consistently named an outstanding place to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies. Look for us on Facebookand follow us on Twitter.
Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.
Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.
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Equal Opportunity
CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.
CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.