Stability and Growth - TOC promotes long-term employment in positions as well as growth opportunities for those who want to further their career goals.
Impact - TOC's team members use our careers - whether in our clinics or our business office - to make a positive difference in the community by building relationships and positively impacting patient lifestyles.
Work Environment - The TOC team focuses on cultivating an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement.
Total Rewards - TOC offers competitive salaries based on the current East Tennessee wage market, plus a comprehensive benefit package, including Medical, Dental, Paid Time Off, Extended Illness Bank and more. Our 401(k) plan provides a company match, safe harbor match and profit-sharing match to go along with your contributions.- Leads, coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
- Conducts thorough background investigation, research and primary source verification of all components of the application file.
- Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
- Prepares credentials file for completion and presentation to Health System Entity Medical Staff Committees, ensuring file completion within time periods specified.
- Processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.
- Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
- Assists with managed care delegated credentialing audits; conducts internal file audits.
- Utilizes credentialing database, optimizing efficiency, and performs query, report and document generation; submits and retrieves National Practitioner Database reports in accordance with Health Care Quality Improvement Act.
- Monitors the initial, reappointment and expirables process for all medical staff, Allied Health Professional staff, Other Health Professional staff, and delegated providers, ensuring compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS, federal and state), as well as Medical Staff Bylaws, Rules and Regulations, policies and procedures, and delegated contracts.
- Performs miscellaneous job-related duties as assigned.
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Credentialing Coordinator - Knoxville, United States - Tennessee Orthopaedic Clinics
Description
Tennessee Orthopaedic Clinics is one of the nation's largest orthopedic networks. TOC offers comprehensive medical and surgical treatment of bone, joint and soft tissue disorders. Our treatment is compassionate, conservative, and prompt, providing patients with the specialized orthopedic care they deserve.There are numerous reasons why TOC is an employer of choice; here are a few of them:
Essential Job Responsibilities:
Education:
High school diploma.
Experience: At least 4 years of experience with 2 years directly related to hospital medical staff or managed care credentialing.
TOC is an equal opportunity employer. TOC conducts background checks on applicants who accept employment offers.
