Credentialing Coordinators work with medical and professional staff applying for appointment or reappointment to any single or combination of Fairview entities to ensure complete, timely and smooth completion of verification and privileging processes. Ensures all processes and verifications meet the National Committee for Quality Assurance and Joint Commissions (JC) standards. Credentialing Coordinators assist in establishing policies, procedures and job duties, and in staff training.
Imports applications and enters data into the credentialing database
Processes applications following policies, NCQA, and JC standards within the established amount of time and assuring quality goals are met
Obtains verifications, run queries
Reviews and assess all verifications to determine eligibility of applicants to meet criteria Flags any issues for further review
Reviews and determines compliance with privilege criteria
Determines completeness of applications through Quality Review processes
Communicates with medical staff offices
Assists in establishing policies, procedures and process improvements
Assists in staff training
Functions as a resource to customers and entities on credentialing and privileging issues
Assists with other duties as assigned
Organization Expectations, as applicable:
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served
Partners with patient care giver in care/decision making
Communicates in a respective manner
Ensures a safe, secure environment.
Individualizes plan of care to meet patient needs.
Modifies clinical interventions based on population served.
Provides patient education based on as assessment of learning needs of patient/care giver.
Fulfills all organizational requirements
Completes all required learning relevant to the role
Complies with all relevant laws, regulation and policies
Performs other duties as assigned.
Minimum Qualifications to Fulfill Job Responsibilities:
Two years business/technical college OR 2 years of experience in a credentialing related position
1 year experience in a credentialing related position. Would consider appropriate similar experience.
Associate degree, medical terminology
2 years of hospital credentialing experience
CPCS or CPMSM certification through the National Association of Medical Staff Services (NAMSS)
Additional Requirements (must be obtained or completed within a period of time):
Organizational skills, attention to detail, written and verbal communication skills. Varied PC and database skills. Strong customer service skills. Excellent critical thinking skills. Must have the ability to use independent judgement to perform a wide variety of tasks professionally.
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership ...with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.