Credentialing Coordinator (Dentistry Practice Plan)

Under general supervision, the Credentialing Coordinator is responsible for assuring the proper credentialing and privileging of physicians, mid-level Providers, research associates, professionals, and paraprofessional individuals within the School of Dentistry. The Credentialing Coordinator will maintain and ensure compliance for all licensure and appointments with state and governmental agencies and certifications for each Provider. The Credentialing Coordinator also tracks and ensures the completion of required continuing medical education courses/workshops.

• Guide Provider through credentialing and re-credentialing process and ensure the completion of required documentation for UT Health School of Dentistry and all facilities where the Provider delivers services.

• Works with Provider to prepare and submit Medicare & Medicaid applications to enrollment office.

• Prepare all credentialing applications, develop, and provide documentation that are not supplied by the Provider, address any additional information or corrections requested.

• Verify and track the proper credentialing and re-credentialing of physicians, professionals, and paraprofessional individuals within UT Health School of Dentistry and all facilities where the Provider has privileges.

• Receive credentialing application and enter data into credentialing system.

• Work with Provider to maintain and ensure compliance for all licensure and appointments with state and governmental agencies and certifications for each Provider, generate monthly report of expiring credentials.

• Ensure ongoing monitoring of performance between credentialing cycles, generate performance review documentation, share with department for completion, and notify external entities when a Provider has been suspended, if necessary.

• Work with Departments to obtain proof of Professional Liability coverage.

• May provide support and information needed for monthly credentialing committee meetings, provide report to the committee of initial and reappointments.

• Notify Providers and departments of credentialing status and final result, email notice to department and provider, ensure credentialing system is updated with final credentialing result.

• Track and ensure the completion of required continuing dental/medical education courses/workshops; provide documentation to outside entities according to requirements.

• Conduct customer service tasks such as responding to Providers, applicants, administrators, and hospital inquiries, provide documents to physicians/office staff seeking copies.

• Perform all other duties as assigned.

• Ability to effectively serve the customer's need

• Strong attention to detail and ensuring accuracy

• Ability to work independently under limited supervision

• Strong multitasking and organizational skills

• Exhibits accuracy and thoroughness; monitors own work for quality

• Strong organizational and time management skills

• Proficiency in relevant software such as MS Office suite

• Strong verbal, written and interpersonal communication skills

EDUCATION:

• High school diploma or GED is required.

PREFERRED:

• Associate’s degree or higher is preferred.
• Certified Credentialing Coordinator is preferred.