Credentialing Coordinator

Description

At DAP Health, we are committed to transforming lives and advancing health equity for all. As a leading nonprofit health care provider, we deliver compassionate, high-quality care to the diverse communities of the Coachella Valley and San Diego County. Our comprehensive services range from primary care to mental health, wellness programs, and beyond, with a focus on those who are most vulnerable. Joining our team means becoming part of a passionate, innovative organization dedicated to making a meaningful impact in the lives of those we serve. If you're looking for a dynamic and purpose-driven environment, we invite you to explore the opportunity to contribute to our mission.

Job Summary: 

The Credentialing Coordinator serves a vital role in maintaining the integrity of DAP Health’s provider network. The primary responsibility of this position is to ensure that all licensed personnel meet the necessary credentialing requirements to work in a Federal Qualified Health Center (FQHC).  

Supervisory Responsibilities: None 

Essential Duties/Responsibilities

Furnish and maintain initial and re-credentialing for all licensed personnel: 

• Furnish and maintain initial and re-credentialing for all licensed personnel: 
• Furnish the appropriate credentialing application packet to providers via DAP Health’s credentialing system 
• Provide re-credentialing applications in advance of its due date to licensed personnel 
• Process the above credentialing applications in accordance with accreditation standards, regulatory requirements, and policies and procedures 
• Serve as main point of contact for internal and external queries regarding applicants’ status, providing responses in a timely manner and additional information as requested 
• Maintain credentialing database continuously and consistently to ensure that the information is accurate and current by partnering with internal departments 
• Monitor and report expiring licensure, board/professional certifications and other expirable documents for all licensed personnel to appropriate internal departments for proper maintenance 
• Uniformly apply clearly defined credentialing and/or privileging processes to all licensed personnel for completion 
• Identify and review credentialing red flags with managers and directors for direction 
• Shared responsibility for reviewing, processing, and distributing incoming correspondences 
• Work collaboratively with other internal departments to maintain compliance as it relates licensed personnel credentialing activities 

Conduct and maintain primary source verification for all licensed personnel: 

• Perform outreach to primary sources to validate applicants’ information 
• Verify and document expiries using acceptable verification sources to ensure compliance with accreditation and regulatory standards 

Manage compliance with accreditation standards and regulatory requirements: 

• Demonstrate an understanding of state and regulatory standards as it relates to credentialing and privileging for licensed personnel in a Federal Qualified Health Center (FQHC) 
• Compile applicants’ sanctions, complaints, and adverse data to ensure compliance 
• Recognize potential discrepancies, adverse information, and independently investigate and validate information provided and report such discrepancies to DAP Health’s internal stake holders, including but not limited to the credentialing committee, for review and directive 

Manage the Credentialing and Privileging Committee: 

• Prepare documents needed for credentialing committee 
• Shared responsibility for leading credentialing committee 
• Retain all records of the DAP Health credentialing committee’s outcomes in the approved shared folders for compliance and audit readiness 
• Perform other assigned duties 

Qualifications

Required Skills/Abilities 

• Knowledge of healthcare regulations, including those related to credentialing regulatory agencies 
• Strong organizational and communication skills 
• Attention to detail and ability to manage multiple tasks simultaneously 
• Proficient in Microsoft Office Suite and navigating the web 

Education and Experience 

• 3-5 years of experience in clinical credentialing 
• Experience working with credentialing software such as MD Staff 
• Working knowledge of some medical terminology 
• Bilingual English/Spanish preferred 

Working Conditions/Physical Requirements 

• This position is fully remote; employee must reside in California. 
• This job operates in a home office setting and requires frequent times of sitting, standing, repetitive motion and talking 
• Able to lift/move up to 50 pounds