Credentialing Coordinator

CHI Williston Health, now part of CommonSpirit Health formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health, have a variety of skills from clinical to project management. In our Critical Access Hospital, you will be exposed to the emergency department, acute care (Med/Surg), swing bed, surgery, outpatient treatment, and so much more! CHI Williston Health provides you with the same level of care you provide for others. We care about our employees' well-being and offer benefits that complement work/life balance.

Supports the direction, coordination, and planning functions of all Credentialing personnel within the policies, scope, and goals set forth by the Fargo Division. This job is responsible for oversight and coordination of the Division Credentialing operations and staff in the local MBO markets. This position will provide consistent, accurate, and timely credentialing support to the local markets, enhancing the Division's ability to provide professional services.

• Coordinates timely and accurate Provider Credentialing across the Division. This includes application, and re-application processes to ensure files are timely, complete, accurate, and in compliance with defined standards. Uses discretion and tact in dealing with highly sensitive and confidential issues.
  
• Responsible to ensure the integrity of data within the Credentialing database, including assuring timely and accurate completion of documents, database entry, and conducting scheduled quality reviews of Credentialing database to include reconciliation of credentialing information with claims system as applicable. Serves as a system administrator for this Credentialing application. Responsibilities include maintenance of tables, permission levels for system of access and/or deletion of system users. System Administrator troubleshoots all system errors, analyzes system errors to determine whether the problem is the software, hardware, or user error and facilitates problem resolution. Trains new users as required.
  
• Responds and troubleshoots difficult inquiries and out of guideline requests from local markets, providers, office, and clinic staff/management, as related to the provider application and credentialing process.
  
• Ensures that the local credentialing staff cultivate and maintain professional relationships with primary customers within areas of responsibility including medical directors, physicians, physician groups, supply vendors, payors, and other credentialing agencies and other external entities to foster opportunities for revenue enhancement, enhanced customer service and to positive impact the core clinic/department measures.
  
• Monitors and assess current operations to identify opportunities for performance and process improvements; recommend ideas to Division leadership; implements approved changes and quality/performance improvements.
  
• Participates in the development and updating of policies and procedures; implements and evaluates new/revised policies and procedures to ensure consistency and compliance with applicable regulator requirements; ensures internal guidelines are documented and understood in accordance with the standards and practices.

Education and Experience

• High School Diploma or GED, Required.
• Bachelor’s degree in related field, Preferred.
  
• 3-5 years of credentialing experience, Preferred.

Licensure and Certifications

• Certified Provider Credentialing Specialist (CPCS), Preferred.
• Prof Medical Services Manager (PMSVSC), Preferred.