The Credentialing Coordinator is responsible for handling the development and implementation of a strategic plan for reviewing primary source verification and other required documentation for the granting of provider privileges.
Responsible for managing all documentation and maintenance of the approved provider roster; and will organize the activities surrounding approval committee.
This position will also assist in the coordination and preparation of other credentialing activities.
Essential Functions/Responsibilities: Collect and store documentation to include primary source verification and facility credentialing information.
Responsible for maintenance of roster of approved providers, and the reporting of monthly and quarterly additions or deletions.
Develop and maintain master list of credentialed providers to include, additions, changes, and deletions.
Assist providers regarding organizational, quality, and operational requirements.
Prepares accurate projections of expected impact of terms and provisions.
Participate in approval and deeming activities and coordinate committee meeting on a regular basis.
Other Duties as assigned.
Qualifications and Education Requirements: Behavioral Health provider and facility credentialing experience a plus.
Bachelor’s degree in Business or related field required.
Minimum 1-3 years experience working in a health care environment; preferably an HMO/PPO.
Working knowledge of Medicare and Medicaid programs preferred.
Advanced proficiency in MS Excel and other applications in the Office Suite.
Preferred Skills: Must have a working knowledge of Medicare and Medicaid programs.
Must possess solid knowledge and understanding of health care industry; and local market conditions.
Experience in delegated credentialing a plus Proficiency in MS Office Suite.
Job Type: Full-time Pay: $45,000.00
– $50,000.00 per year Benefits: 401(k) Dental insurance Disability insurance Flexible spending account Health insurance Life insurance Paid time off Vision insurance Schedule: 8 hour shift Day shift Monday to Friday Education: Bachelor’s (Preferred) Experience: Provider Credentialing: 1 year (Required) Medicare & Medicaid: 1 year (Preferred) Health care environment: 1 year (Preferred) Work Location: One location Work Remotely: Temporarily due to COVID-19 Work Location: One location by Jobble