US
0 suggestions are available, use up and down arrow to navigate them
PROCESSING APPLICATION
Hold tight! We’re comparing your resume to the job requirements…
ARE YOU SURE YOU WANT TO APPLY TO THIS JOB?
Based on your Resume, it doesn't look like you meet the requirements from the employer. You can still apply if you think you’re a fit.
Job Requirements of Credentialing Coordinator:
-
Employment Type:
Contractor
-
Location:
Rhode Island, US (Onsite)
Do you meet the requirements for this job?
Credentialing Coordinator
Careers Integrated Resources Inc
Rhode Island, US (Onsite)
Contractor
Job Title : Credentialing Coordinator
Location: Fully Remote
Job Duration : 6+ Months
Shift: MON - FRI 8:00-4:30
Position Summary:
Roles & Responsibilities:
Required Skills:
Education:
Location: Fully Remote
Job Duration : 6+ Months
Shift: MON - FRI 8:00-4:30
Position Summary:
- The Credentialing Coordinator is responsible for initial credentialing and re-credentialing nurse practitioners, physician assistants and physicians in a compliant and timely manner; monitor expired credentials and compliance monitoring in accordance with Joint Commission accreditation, NCQA and URAC credentialing standards as required.
Roles & Responsibilities:
- Responsible for the timely and accurate processing of all providers including NP s/PA s/MD s initial and Re-credentialing applications according to the Minute Clinic Provider Credentialing Program
- Monitor Expired licensure reporting , data base tasks and maintain system updates and weekly reporting to leadership
- Manage Epic access for any providers that have out of compliance licensure and/or board certification.
- Conduct sanctions and compliance monitoring and alert Credentialing Manager and Revenue Director of any undisclosed negative findings
- Process malpractice insurance verification requests according to internal policies
- Maintain the provider and physician SharePoint sites and Communicate provider statuses with leadership and other internal teams to meet timelines
- Submit system access requests upon credentialing approvals/clinic eligibility
- Support the payer enrollment team as needed to resolve any payer claim issues
- Monitor Provider and Clinic change/Termination reports and update data base accordingly
- Process Name changes according to Minute Clinic policies and procedures
- Daily maintenance of provider credentialing grids with notification to appropriate teams
- Review and distribute all incoming mail as needed
- Support Payer Audits in accordance with Minute Clinic, Joint Commission and NCQA requirements
- Maintain provider files with the most current information/documentation
- Notify system analyst and leadership of any system and state agencies interruptions/updates/password changes
- Make recommendations for process improvement and system efficiencies
- Attend and engage in all team meetings
- Model a positive attitude in interactions with team members
Required Skills:
- Demonstrated understanding of initial credentialing and re-credentialing practices for medical professionals including primary source verification methods, compliance monitoring and expireables management.
- Proficient in quantitative analysis
- Understanding of Joint Commission Accreditation, NCQA and URAC credentialing standards.
- Ability to function independently and utilize critical thinking skills to accomplish goals and objectives
- Effective communication skills; verbal and written
- Strong interpersonal skills including the ability to work well with internal and external stakeholders
- Strong organizational skills and the ability to multitask
- Competent user of Microsoft Office, Outlook, Word, and Excel
- A minimum of 3 years experience in the healthcare industry with experience in credentialing
- NAMSS Certified Professional Credentialing Specialist (CPCS) certification
Education:
- Verifiable High School Diploma is required.
- Associates or bachelor s in business preferred.
Get job alerts by email.
Sign up now!
Join Our Talent Network!