<p>SUMMARY: The Credentialing Coordinator is responsible for providing administrative and technical support to credentialing services and functions.</p> <p>DUTIES AND RESPONSIBILITIES:</p> <ul> <li>Populates, updates, and maintains credentialing software and filing systems </li><li>Processes request, investigation, verification, tracking and follow up of primary responses from various sources. </li><li>Identifies, investigates, reports, tracks, and forwards to credentialing team for follow-up on any potentially adverse information received from credentialing sources. </li><li>Obtains and maintains appropriate knowledge of company policy and procedures, accreditation standards, state and federal regulations, guidelines, procedures and laws required in credentialing process. </li><li>Assists with Requests for Proposals or any requested reports as necessary and in collaboration with supervisor or other Credentialing Services staff. </li><li>Maintains practitioner files annually or on an as needed basis. </li><li>Collects site visit information from Provider Relations on appropriate practitioner files & maintains credentialing software and filing systems </li><li>Works with Credentialing team to identify and coordinate any risk management, substance abuse and/or malpractice issues. Reviews files for any "red flag" concerns. </li><li>Maintains strict confidentiality of all records, data and occurrences as condition of initial and/or continued employment. </li><li>Responsible for complying with Paradigm IT security requirement and policies. </li><li>Responsible for safeguarding Paradigm or Paradigm related IT passwords. </li><li>Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management. </li></ul> <p>QUALIFICATION REQUIREMENTS: To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p> <ul> <li>Exceptional communication and telephone skills required, as well as a great deal of patience and understanding. </li><li>Experience working with physicians and/or senior executives preferred. </li><li>Possess a high level of self-confidence and persistence; maintain an assertive approach in dealing with providers. </li><li>Must possess excellent organizational skills and the ability to multi-task effectively. </li><li>Demonstrate the ability to prioritize heavy workload and work independently with minimal supervision. </li><li>Proficient computer and internet skills; familiarity with Microsoft Office software required. </li><li>Knowledge of medical terminology preferred. </li><li>Will develop in-depth knowledge of department and company internal workflows including, but not limited to individual state's procedures and negotiating protocols. </li><li>Bilingual a plus. </li></ul>