Credentialing Coordinator -ANES

Overview

MEDNAX has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide:

• physician services spanning the continuum of patient care
• revenue cycle management solutions
• performance improvement consulting

We invite you to grow with us and help shape the future of health care.

Responsibilities

Responsible for critically evaluating credentialing and recredentialing applications, and performing pre-screening, credentialing and recredentialing. Conduct primary source verification of credentials in accordance with established standards, department policies & procedures, requirements of the Credentials Committee and delegated health plans. Enter and maintain accurate and updated information in database and provider files.

• Create, update and maintain accurate provider information in Workview 
• Review credentialing application for completeness, log and request missing documentation
• Critically evaluate application for any issues that may require special consideration, or additional review, and take appropriate action to resolve issue
• Perform primary source verification of license, DEA, Board Certification, NPDB highest level of education, other verifications as defined by management
• Comply with Credentialing policy and departmental guidelines
• Respond to Team Leads and Clinical Staffing Specialist, as well as others assigned with management responsibility for the process, providing status updates within one business day, from receipt of request
• Comply with established timelines for processing files 
• Notify Supervisor of any quality issues regarding file 
• Coordinate with Clinical Staffing Specialist to obtain required information from provider
• Monitor and track responses from primary sources and send follow-up requests as needed until file is complete
• Prepare check requests for required verification fees
• Participate in the preparation of files for credentialing committee meetings, delegated credentialing audits and desktop audits
• Identify providers due for recredentialing
• Conduct self-audits to ensure data integrity in Workview 
• Work with supervisor in identifying back-up coverage and assigning files when out of the office
• Document all tasks, phone calls, emails and other forms of communication during the credentialing/recredentialing process.
• Perform self-audits to ensure data integrity in Workview and provider files
• Assist in preparation of files for Credentialing Committee meetings, delegated credentialing audits and desktop reviews
• Scan or print verifications and other documents, as necessary
• Complete other tasks or projects as assigned
• Provide back-up to other Credentialing staff as necessary

Qualifications

2+ years credentialing experience, CPCS Credentialing Certification preferred.Excellent computer skills, In-depth knowledge of credentialing process, self-starter, detail-oriented, excellent customer service skills

MEDNAX IS AN Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status