• Coordinates the processes for medical staff/advanced practice professional credentialing • Verifies and collects documents that support eligibility threshold for privileges • Processes initial and reappointment applications and privileging requests • Creates accurate credentialing reports for review and recommendations

• Supports the CVO’s application process, credentialing verification, expirable management and ongoing monitoring work for contracted healthcare organizations. • Ensures clients and providers have a positive experience by providing quality service and communication. • Coordinates provider application and primary source verification process using CVO credentialing platform. • Manages provider application process including sending electronic applications to providers per client requests, evaluating the received application for completeness, resolving incomplete application information, accepting information into credentialing platform following CVO policies and procedures. • Communicates with applicants and designated administrative support to resolve application requirements and incomplete data in a professional manner. • Manages primary source verifications for provider applications including ensuring the verification of credentialing information from the provider’s application is correct and from primary sources, tracking fees for verifications, following up on non-received verifications needed to close files, and tracks information following CVO policies and procedures. • Communicates professionally with applicants, designated administrative support and primary source organizations on verification discrepancies, information needs and requirements. • Manages ongoing expirables for providers primary state license, board certification, DEA/CDS and malpractice insurance for contracted clients. • Manages ongoing monitoring of sanctions for contracted clients for state licenses, Medicare and Medicaid and Medicare Opt-Out. • Provides a monthly report of outcomes. • Stays informed on all client criteria requirements to ensure requirements are applied to files through the application and verification process. • Communicates with providers and client questions and concerns regarding a variety of issues related to the processing of credentialing applications. • Tracks and obtains fee verifications; follows department policies and procedures standards for check requests and credit card usage. • Supports the billing process for verification services. • Maintains and updates the database reference tables in accordance with internal policies and procedures with current contact information following data standardization protocols. • Maintains own professional growth through participation in seminars, conferences, in-service programs and self-directed learning activities. • Contributes to the team efficiency by providing support both operationally and administratively. • Assists with special projects and tasks as requested.

• Responsible for all aspects of the initial credentialing, re-credentialing and privileging functions for all clinicians on medical and allied health staff at the VCU Health System Hospitals • Interacting with clinicians to obtain applications and pertinent documents • Evaluating data for accuracy and completeness • Monitoring receipt and follow up responses ensuring timely and efficient processing • Notifies supervisor Director of any adverse, incomplete or questionable data • Works independently and assesses situations, considers alternatives, and chooses the appropriate course of action • Demonstrates sound organizational ability and effectively sets priorities • Maintains strict confidentiality and professional discretion • Ensures compliance with hospital bylaws, and with local, state and federal requirements • Provides assistance to the Director in development, plans, organization and control of the operation of the Medical Staff Office • Attends medical staff committee meetings as directed • Interacts and provides support services to medical staff officers, departments and chairs as assigned

• Facilitate the accurate and efficient Credentialing and Recredentialing of Medicaid Business Segment providers • Ensure timely and accurate processing of credentialing and recredentialing for both individual practitioners and organizations • Coordinate Credentialing Committee meetings • Identify and communicate agenda items for Credentialing Committee to immediate leader • Facilitate prompt coordination with the Credentialing Verification Organization (CVO) • Review and maintain all applications for accuracy and completeness • Accurately and efficiently data enter primary source verification data into the credentialing database • Generate and mail approval letters to participating providers • Communicate with Network Services regarding status of provider and organizational credentialing