CHC follows the CMS requirements which requires all team members to obtain a COVID-19 vaccination.

A career at Community Health Centers offers a unique opportunity to join a team that makes a real impact in our community every day, by improving individuals' health while enhancing their quality of life.

Top Reasons to Work at Community Health Centers

• A great benefits package that includes healthcare coverage, paid time off, paid holidays, retirement plan, and more.
• Competitive compensation with advancement opportunities and tuition / training reimbursement.
• Awarded "Best and Brightest Companies to Work for in the Nation" in 2018, 2019, 2020, and 2021.
• Awarded "Top 100 Workplaces for Growing Families" by Orlando Sentinel.
• Modernized and attractive health centers, that patients love.

Job Summary:

The Credentialing Coordinator works with all clinical members staff and external sources to ensure compliance with CHC Credentialing and Human Resources Policies, AAAHC, HRSA and FTCA standards and guidelines and other applicable federal, state and local regulatory and/or accrediting agencies. The Credentialing Coordinator is responsible to facilitate all aspects of credentialing, including appointment, reappointment, monitoring, privileging for all LIP, OCLP and OCS. This position supports the general business operations of CHC and its customers.

Primary Responsibilities and Specific Duties:

• Maintains current knowledge of AAAHC, HRSA, FTCA clinical staff credentialing standards and state and federal requirements.
• Reviews and maintains the confidentiality of information and materials that may include sensitive or adverse information.
• Summarizes adverse reports for Executive Leadership and Chiefs
• Leads and participates in credentialing projects, researching regulatory and industry standards to identify approaches to new or existing project implementation, and presenting research and recommendations to her Leader, CMO or CDO
• Provides and implements recommendations for process and procedure workflow changes.
• Conducts provider credentialing and re-credentialing, including performing Primary Source Verifications
• Monitors the status of credentialing applications and requested information.
• Researches and analyzes complex credentialing issues and develops and proposes solutions.
• Coordinates Credentialing Committee meetings
• Responsible for all verified information and prepares credentials files for:
  • Presentation to the VP/Chief Medical Officer, VP/Chief Dental Officer, and Chiefs
• Credentialing Committee
• Board of Directors
• Disseminate information to other CHC departments as required.
• Coordinates hospital privilege initial/reappointment process with clinicians when/where indicated.
• Coordinates providers and clinical staff training and access to Credential Stream
• Accept and process through the appropriate committees all requests for additions/deletions of privileges and/or changes in staff status.
• Notify each staff member approximately 90 days before the expiration of the individual's term of appointment of the need to complete and return the reappointment profile.
• Compile, prepare, copy and distribute correspondence, memorandums to obtain information from a variety of sources.
• Assists with Physician Recruitment and credentialing process.
• Assists with Provider Contract
• Executing initial and renewal contract
• Knowledge of contract language
• Responsible for maintaining providers AHCA backgrounds.
• Main contact between Managed Care and Credentialing Dept for providers AHCA backgrounds (initial and renewals)
• Facilitates Credentialing session during Management Essentials
• Facilitates Credentialing session during Foundations.
• Oversees coordination of BLS classes to include creating classes in e3.
• Performs ongoing monitoring of license status and state and federal sanctions of contracted and non-contracted providers and all clinical staff and conducts investigations.
• Performs ongoing monitoring of Medicare/Medicaid sanctions, Florida Suspended and Ineligible Providers, and various Medical Board license status issues.
• Coordinates professional license renewals for all licensed clinical staff.
• Lead Credentialing Trainer

Qualifications:

Education:

• High school degree required; Associate degree (or two years' college) preferred.

Experience:

• Must have at least five (5) years' experience in Credentialing and Privileging in healthcare setting
• Provider enrollment/credentialing software

Certifications/Licensure:

• Certified Provider Credentialing Specialist preferred or must be obtained within 24 months of employment.

Special Skills:

• Good written and verbal communications.
• Ability to meet deadlines and prioritize, along with good organizational skills.
• Computer skills (Microsoft Office, emphasis on Word and Excel).
• Ability to interpret and follow complex directions.