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Job Requirements of Credentialing Coordinator:
-
Employment Type:
Contractor
-
Location:
New York, NY (Onsite)
Do you meet the requirements for this job?
Credentialing Coordinator
Careers Integrated Resources Inc
New York, NY (Onsite)
Contractor
Pay - $25/hr. - $30/hr
Shift - Hybrid 9-5 (Thursdays Mandatory) First week training on-site
Duties:
Purpose of Position: Health Plan is seeking an individual to join our Provider Services team in the capacity of Credentialing Coordinator. The responsibilities of this position include but are not limited to perform most tasks related to the credentialing of new providers, including document collection and verification, and provider credentialing file maintenance. Also ensure that all credentialing supporting documentation is confidential and maintained in a secure environment.
As well as assisting facilities and providers in understanding and adhering to policies and procedures regarding the credentialing process. Key Responsibilities: 1. Maintain communication with the credentialing contacts at facilities and provider sites to coordinate receipt of information required for credentialing, re-credentialing, and update of provider credentialing information
2. Review provider-credentialing file for completion and presentation to the Credentialing Committee 3. Perform primary source verification on required elements and in accordance with policies and procedures
4. Data entry and upkeep of provider information in the credentialing database 5. Verify New York State OProduct and Medicare/Medicaid for any current sanctions, restrictions on licensure and/or limitations on the Product of practice on all credentialed providers in interim credentialing periods 6. Generate and disseminate monthly provider credentialing updates to appropriate departments at Health Plan and participating facilities and providers 7. Create, copy, file, and maintain all relevant documentation into provider credentialing folder 8. Perform annual delegated file audits and participate in pre-delegation and delegation site reviews
9. Respond to inquiries from other departments relative to a provider s credentialing status
10. Performs other related tasks as directed by the Director of Provider Services and the Credentialing Manager
Skills:
Excellent communication and organizational skills Previous experience with provider credentialing processes and procedures Knowledge of ClientC credentialing policies and procedures preferred Good computer skills and able to work with MS Office Knowledge of CACTUS preferred
Schedule Start Date:
08/11/2025
Schedule Start Date:
08/11/2025
Schedule Hours Per Week:
40.00
Schedule Hours Per Day:
8.00
Schedule Notes:
Hybrid 9-5 (Thursdays Mandatory) First week training on-site Maintain communication with the credentialing contacts at facilities and provider sites to coordinate receipt of information required for credentialing, re-credentialing, and update of provider credentialing information
Review provider re-credentialing and credentialing file for completion and presentation to the Credentialing Committee.
Perform primary source verification on required elements and in accordance regulatory guidelines and Health s policies and procedures Data entry and upkeep of provider information in the credentialing and other pertinent databases
Verify New York State OProduct, Medicare/Medicaid lists and other pertinent databases for any current sanctions, restrictions on licensure and/or limitations on the Product of practice on all credentialed providers in interim credentialing periods
Verify New York State license registration and DEA registration status for all credentialed providers in the interim credentialing periods Generate and disseminate monthly provider credentialing updates to appropriate departments at Health and participating facilities and provider groups
Review and respond to request for credentialing information/copies of credentialing files to appropriate departments within Health Generate and disseminate provider rosters to delegated facilities, contracted group practices etc.
Perform provider roster reconciliation Create, copy, file, and maintain all relevant documentation into provider credentialing folder.
Maintain confidentiality of provider credentials by filing the credentialing folder in
Shift - Hybrid 9-5 (Thursdays Mandatory) First week training on-site
Duties:
Purpose of Position: Health Plan is seeking an individual to join our Provider Services team in the capacity of Credentialing Coordinator. The responsibilities of this position include but are not limited to perform most tasks related to the credentialing of new providers, including document collection and verification, and provider credentialing file maintenance. Also ensure that all credentialing supporting documentation is confidential and maintained in a secure environment.
As well as assisting facilities and providers in understanding and adhering to policies and procedures regarding the credentialing process. Key Responsibilities: 1. Maintain communication with the credentialing contacts at facilities and provider sites to coordinate receipt of information required for credentialing, re-credentialing, and update of provider credentialing information
2. Review provider-credentialing file for completion and presentation to the Credentialing Committee 3. Perform primary source verification on required elements and in accordance with policies and procedures
4. Data entry and upkeep of provider information in the credentialing database 5. Verify New York State OProduct and Medicare/Medicaid for any current sanctions, restrictions on licensure and/or limitations on the Product of practice on all credentialed providers in interim credentialing periods 6. Generate and disseminate monthly provider credentialing updates to appropriate departments at Health Plan and participating facilities and providers 7. Create, copy, file, and maintain all relevant documentation into provider credentialing folder 8. Perform annual delegated file audits and participate in pre-delegation and delegation site reviews
9. Respond to inquiries from other departments relative to a provider s credentialing status
10. Performs other related tasks as directed by the Director of Provider Services and the Credentialing Manager
Skills:
Excellent communication and organizational skills Previous experience with provider credentialing processes and procedures Knowledge of ClientC credentialing policies and procedures preferred Good computer skills and able to work with MS Office Knowledge of CACTUS preferred
Schedule Start Date:
08/11/2025
Schedule Start Date:
08/11/2025
Schedule Hours Per Week:
40.00
Schedule Hours Per Day:
8.00
Schedule Notes:
Hybrid 9-5 (Thursdays Mandatory) First week training on-site Maintain communication with the credentialing contacts at facilities and provider sites to coordinate receipt of information required for credentialing, re-credentialing, and update of provider credentialing information
Review provider re-credentialing and credentialing file for completion and presentation to the Credentialing Committee.
Perform primary source verification on required elements and in accordance regulatory guidelines and Health s policies and procedures Data entry and upkeep of provider information in the credentialing and other pertinent databases
Verify New York State OProduct, Medicare/Medicaid lists and other pertinent databases for any current sanctions, restrictions on licensure and/or limitations on the Product of practice on all credentialed providers in interim credentialing periods
Verify New York State license registration and DEA registration status for all credentialed providers in the interim credentialing periods Generate and disseminate monthly provider credentialing updates to appropriate departments at Health and participating facilities and provider groups
Review and respond to request for credentialing information/copies of credentialing files to appropriate departments within Health Generate and disseminate provider rosters to delegated facilities, contracted group practices etc.
Perform provider roster reconciliation Create, copy, file, and maintain all relevant documentation into provider credentialing folder.
Maintain confidentiality of provider credentials by filing the credentialing folder in
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