What are the responsibilities and job description for the Credentialing Coordinator position at The French Agency?
Position Overview: The Credentialing Coordinator coordinates the physician and mid-level payor enrollment and hospital privilege credentialing applications process. They are responsible for preparing and submitting credentialing applications and supporting documentation to enroll individual providers and clients with payors and the hospital.
Experience
- Minimum of 2 years of credentialing and/or provider enrollment experience in a medical setting
- Minimum of 5 years of Medicare, Medicaid, and Commercial Insurance credentialing experience
Duties and Responsibilities:
- Coordinates the physician enrollment and hospital credentialing process
- Maintains the timelines on enrollment/credentialing schedules, communicates with providers and other departments to update as needed, and maintains a strict level of confidentiality for all matters pertaining to provider credentials
- Communicates with billing and the office managers on updates as needed and explains payor info requirements
- Coordinates credentialing data needed for onboarding, contracting, and other related purposes (credentialing data includes, but is not limited to, the medical degree, DEA number, state license number, Board certifications, CV, malpractice insurance and state insurance form)
- Obtains missing documentation pertaining to the onboarding and reappointment process, obtains required provider signatures, and follows up with the entities on documentation submitted
- Maintains provider info and demographics for all providers
- Responds to internal and external inquiries on routine credentialing and contracting matters
- Monitors and ensures current documentation is obtained for medical licensure, DEA, CDS, COI, TB, flu, etc.
- Runs OIG report on onboarding providers
- Maintains quarterly health plan rosters
- Creates and maintains provider CAQH
- Ensures prompt payment for provider hospital dues
- Performs other duties as required assigned, or requested
Desired Qualifications:
- Knowledge of CAQH, NPDB, OIG and other regulatory agencies
- Knowledge of Athena medical billing preferred
- Proficiency with Microsoft Office Suite
- Possess strong organizational and time management skills
- Detail oriented, professional attitude, and reliable
- Ability to define, analyze, and resolve issues quickly and accurately
- Ability to interact with internal and external customers in a professional manner
- Ability to manage multiple priorities successfully and drive results
- Ability to communicate effectively both verbally and in writing
- Ability to maintain complete confidentiality in handling sensitive enrollment issues
Current software is Track Manager - switching to Verifiable software.
- Experience using credentialing software preferred
- Hospital privileging experience, including but not limited to primary sourcing
Must have High School Diploma or equivalent.
Contract to hire - hired on after 650 hours and will receive full benefits.
In-office position with the opportunity to pick your start time. Virtual interview will be conducted by the direct supervisor.
Environment and/or Physical Factors
- This job operates in a professional office environment
- This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines
- While performing duties of this job, the employee is regularly required to frequently sit, stand, walk, stoop, kneel, climb stairs and reach with hands and arms
- The employee may be required to lift and move up to 25 pounds
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