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What Does a Credentialing Coordinator Do?

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  • Written By: Licia Morrow
  • Edited By: C. Wilborn
  • Last Modified Date: 02 December 2016
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A credentialing coordinator works in health care and manages the credentials of medical staff members at an organization. This type of coordinator is responsible for evaluating adherence to state or regional regulations governing education and professional preparation, as well as maintaining records and proof of the paperwork associated with compliance. A credentialing coordinator spends time researching rules and mandates, imputing and editing database information, and working closely with license boards and care providers.

When a physician or other health care worker is hired at a medical facility, this coordinator must review and collect proof of the individual's medical degrees, certificates, and job experience. She will likely be a part of the review and hiring process, ensuring that a candidate possesses adequate job preparation and knowledge. She may assist a potential candidate in contacting the appropriate agencies to receive documentation. A coordinator of this type might also work on contacting personal and professional references, and verifying employment either by phone or mail. A credentialing coordinator may also evaluate a candidate's suitability based on this research, and communicate this analysis to others on the hiring committee.

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The duties of a medical coordinator of this type include maintaining collected records as well. Often, these records are gathered, entered into a database, and maintained and organized by the coordinator. The coordinator also extricates these files from the database upon request. Once an employee is hired, the coordinator will also contact the appropriate licensing agencies to obtain forms and assist in filing them, so an employee remains in compliance.

Not only must the coordinator maintain these files, she must communicate their contents to certain people within the medical facility. She is responsible for communicating with care providers to ensure they are aware of upcoming deadlines and training arrangements. She is also in charge of alerting management to any deviation from standards that may result in non-compliance with the law. The coordinator also may be the point of contact for patient inquiries. If a patient is interested in the credentials of a physician or nurse, he may ask the credentialing coordinator for further information and documentation.

It is important for a credentialing coordinator to stay current on licensing rules and regulations, especially if and when laws and codes change. Health care workers are expected to maintain current credentials and the coordinator must continually review regulations to ensure that all employees comply with new standards. Often, the coordinator will need to review new information from regional and national accreditation organizations.

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