Medical Staff Credentialing Coordinator

Inova Center for Personalized Health is looking for a dedicated Medical Staff Credentialing Coordinator to join the team. This role is Full-time working Monday-Friday | Hybrid

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Featured Benefits:

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
• Retirement: Inova matches the first 5% of eligible contributions - starting on your first day.
• Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules.

Medical Staff Credentialing Coordinator Job Responsibilities:

• Processes practitioner applications for initial appointments and/or reappointments. Communicates status of application to practitioners and all interested parties on a regular basis per policy.
• Manages, supports and maintains credentials files on all medical staff members and advanced practice providers. Consults and works with other hospital departments to coordinate process.
• Assures compliance with regulatory requirements and accrediting body standards, Bylaws and policies and maintains current knowledge.
• Plays a proactive role in improving processes within the department for maximum efficiency by participating/leading process improvement activities.
• Appropriately identifies, communicates and investigates extraordinary information, time gaps and potential discrepancies and adverse information, and independently investigates and validates information on applications, primary source verifications or other sources.
• Manages, supports and maintains the Network Insurance Credentialing process for employed practitioners.
• Completes audit updates on Network Insurance files.
• Obtains additional information for all Network Insurance applications with pending and closed lawsuits per policy.
• Works to ensure applications are completed within the required timeframe to meet the appropriate Credentialing Committee Deadlines whenever possible.
• Reviews Privilege request forms for accuracy and provides criteria as appropriate. Notifies practitioner that privilege will be withdrawn if criteria not received by deadline.
• Complete evaluation of pre-application/application to determine applicant's initial eligibility for membership.
• Maintain credentialing database continuously and consistently to ensure that accurate and current information is available to all stakeholders.
• Provides mentorship to credentials specialists. Assists with orientation of staff and provides direction to department resources.
• Provides assistance with questions and directs staff to appropriate resources to educate.
• May perform other duties as assigned.

Minimum Qualifications:

• Education: High School diploma or equivalent
• Experience: 2 years of experience in a healthcare setting or customer service

Preferred Requirements:

• At least 2 years of Medical Staff Credentialing experience (not payer credentialing)