Credentialing Coordinator - Medical Staff Services

Under the direction of the Credentials Verification Organization (CVO) leadership the Credentialing Coordinator is responsible for managing all credentialing and privileging activities for the organized medical staff. This includes ensuring compliance with internal bylaws, policies, and external accreditation standards such as The Joint Commission, CMS Conditions of Participation, and state laws. The role involves application management, verification of credentials, maintenance of files and expirable, and supporting evaluation and decision-making processes. The Credentialing Coordinator serves as a liaison between physicians and leadership, guiding medical staff through credentialing processes and generating documentation to support findings. The position requires adherence to Tampa General Hospital's mission, vision, and values.

Essential Functions:

• Manage initial and reappointment credentialing applications, ensuring completeness and compliance with internal and external standards.
• Verify credentials, including education, training, licensure, certifications, and work history, through primary source verification.
• Maintain accurate and up-to-date credentialing files (electronic and/or hard copy) and track expirables such as licenses and certifications.
• Support the evaluation and decision-making process for granting privileges by providing accurate documentation and analysis.
• Ensure timely processing of credentialing activities to facilitate onboarding of new physicians and reappointments.
• Communicate effectively with medical staff, department chiefs, and leadership regarding credentialing requirements and status updates.
• Monitor compliance with accreditation standards, CMS Conditions of Participation, and state regulations related to credentialing and privileging.
• Identify and escalate potential quality-of-care or behavioral issues discovered during credentialing reviews.
• Represent administrative issues and foster collaboration between physicians and hospital leadership.
• Participate in continuing education, mandatory training, and professional development to maintain current knowledge of credentialing standards and best practices.

Education Qualifications:

• Associate’s Degree Healthcare Administration
• Associate’s Degree Related Field

Experience Qualifications:

• Associate’s degree with three (3) years of Credentialing experience OR Bachelor’s degree with two (2) years of credentialing experience.

Skills and Abilities:

• Comprehensive understanding of medical staff bylaws, rules, and regulations, as well as external agency requirements (The Joint Commission, CMS, state laws).
• Ability to manage complex credentialing files, verify credentials, and maintain accurate records to ensure compliance and timely processing.
• Capacity to identify issues in credentialing processes, analyze information, and recommend solutions to maintain quality and compliance.
• Strong verbal and written communication skills to interact diplomatically with physicians, leadership, and external agencies.
• Ability to prioritize tasks, manage multiple deadlines, and work efficiently in a high-stress environment with frequent interruptions.
• Skilled in using credentialing software systems, electronic file management, and standard office applications