Credentialing Coordinator

Responsibilities:

• Coordinate, monitor, and maintain the credentialing and re- credentialing of provider applicants.
• Facilitate all aspects of appointment, reappointment, and privileging maintenance for managed care, medical staff, and non-physician providers.
• Assist in compliance with the contracted managed care payers, accrediting and regulatory agencies (i.e., NCQA, Joint Commission, URAC), in regards to credentialing while developing and maintaining a working knowledge of the organizational guidelines, statutes and laws.
• Collect relevant and critical data to determine applicant's eligibility to be credentialed.
• Evaluate and review applications for accuracy and completeness.
• Gather and conduct primary source verifications of confidential healthcare provider credentials.
• Contact and follow up with applicant, primary source organizations department and contracted Medical Staff Offices to obtain documentation relevant to the credentialing process and data entry of all credentialing information provided.
• Maintain the confidentiality of all business, work, and credentialing information.
• Assist in managing the flow of information between the managed care payers and MSO facilities.

Qualifications:

• High school diploma or GED required.
• At least 3 years of credentialing experience in working with a CVO (Credentials Verification Organization) or medical staff office.
• Excellent organizational skills and attention to detail.
• Certification from National Association of Medical Staff Services (CPCS/CPMSM) preferred.

Here is more information:

Position: Credentialing Coordinator

Term: 6+ month

Schedule: Remote, Monday-Friday 8am-5pm CST

Pay: $25-30/hr