Job Summary:
Aptive seeks a Medical Credentialing Coordinator/Medical Credentialist to support the credentialing process, including verifying licenses, certifications, education, training, and professional references for a healthcare staffing program. The candidate will ensure that healthcare professionals meet the necessary qualifications and credentials required for employment or affiliation with a healthcare facility.
Our team values a low-ego, psychologically safe and accountable work environment. We function best with a high degree of quality assurance, teamwork, open communication and collaboration. The role involves handling confidential information, providing a positive employee experience, and supporting smooth operations in alignment with company policy and government requirements.
This is a fully remote telework position. A hybrid work schedule is available by request for candidates within commuting distance of Old Town Alexandria, VA.
Primary Responsibilities:
- Credentialing Process Management:
- Oversee the credentialing process for healthcare professionals, including physicians, nurses, allied health professionals, and other staff members.
- Maintain accurate records of credentialing documentation and ensure compliance with organizational policies and regulatory requirements.
- Coordinate with internal departments and external organizations to obtain necessary credentials and verifications.
- Process applications to obtain licenses and hospital privileges on behalf of new and existing providers as needed
- Generate and send verification letters needed for licensure
- Complete all necessary and appropriate forms for PSV and file in preparation of Credentialing Committee review
- Prepare check requests for required verification fees
- Maintain and update VMS/ATS technology with status and necessary data elements
- Document all tasks, phone calls, emails and other forms of communication during the credentialing and recredentialing process in the ATS database
- Conduct written and oral follow up to determine application status
- Escalate all issues to the appropriate members of the management staff, region, and/or co-workers as necessary
- Respond promptly to all questions, received via phone or email, regarding any license and/or privilege
- Participate in the delegated credentialing audit process as needed
- Coordinates aspects of drug screen testing, criminal background checks and case logs according to site credentialing requirements
- Assists with the site credentialing process including gathering and documenting facility requirements and assisting healthcare professionals in obtaining necessary requirements to ensure assignment start dates are met
Verification and Documentation:- Verify the accuracy and authenticity of licenses, certifications, education, training, and other credentials required for healthcare professionals.
- Collect, review, and maintain documentation related to credentials, including application forms, resumes, references, and background checks.
- Ensure that all credentialing documentation meets established standards and is kept up-to-date.
- Assesses healthcare professional credentials for deficiencies to standard and communicates to production when a healthcare professional cannot be accepted.
Compliance and Quality Assurance:- Ensure compliance with applicable laws, regulations, and accreditation standards related to credentialing and privileging processes.
- Conduct periodic audits to assess the quality and completeness of credentialing files and processes.
- Identify and address any discrepancies, deficiencies, or issues related to credentialing.
Communication and Collaboration:- Communicate effectively with healthcare professionals, administrative staff, and external agencies regarding credentialing requirements and processes.
- Collaborate with internal stakeholders to facilitate the credentialing process and resolve any issues or concerns.
- Serve as a resource for staff members regarding credentialing policies, procedures, and requirements.
- Communicates expiring documents to the assigned Recruiter and assist as necessary to ensure that updated documentation is collected
Continuous Improvement:- Participate in ongoing training and professional development to stay informed about changes in credentialing standards, regulations, and best practices.
- Identify opportunities for process improvement and contribute to the development and implementation of new policies and procedures.
- Support organizational initiatives aimed at enhancing the efficiency and effectiveness of the credentialing process.
Additional Duties:- Monitors and tracks candidate pipeline progress and ensures that new healthcare professionals are being processed in a timely manner.
- Reaches out and emails candidates about onboarding progress, and additional or missing documents that are needed to move forward.
- Supports an overall positive employee experience by answering or appropriately escalating employee questions and concerns.
Minimum Qualifications:
- Bachelor's degree in healthcare administration, human resources, business administration, or a related field.
- At least 2 years of relevant expereince
- Previous experience in medical staff services, credentialing, or healthcare administration.
- Strong attention to detail, organizational skills, and ability to manage multiple tasks simultaneously.
- Excellent communication, interpersonal, and problem-solving skills.
- Proficiency in Microsoft Office applications and credentialing software systems.
- Able to obtain and maintain a public trust clearance
- Legal Authorization to work in the U.S.
Desired Qualifications:
- Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) credential.
About Aptive:
Aptive is a modern federal consulting firm focused on human experience, digital services, and business transformation. We harness creativity, technology, and culture to connect people and systems to impact the world. We’re advisors, strategists, and engineers focused on people, above all else.
We believe in generating success collaboratively, leaving client organizations stronger after every engagement and building trust for the next big challenge. Our work inspires people, fuels change and makes an impact. Join our team to be part of positive change in your community and our nation.
EEO Statement:
Aptive is an equal opportunity employer. We consider all qualified applicants for employment without regard to race, color, national origin, religion, creed, sex, sexual orientation, gender identity, marital status, parental status, veteran status, age, disability, or any other protected class.
Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are highly encouraged to apply.
