Credentialing Coordinator jobs in the United States

Responsibilities

Performs all physician and company credentialing functions including physician licensure, malpractice claims, updating curriculum vitaes, health plan contracting and maintains continuing education credits.

• Credential / Enroll all new physicians with participating carriers in a timely and efficient manner.
• Assists with all aspects of the Insurance provider enrollment process for the organization.
• Maintains an accurate database of all physician participation information.
• Run expiring provider reports and obtain copies of medical licensures, and other required expirables for enrollment and CAQH
• Maintains excellent relations between payers, and providers.
• Informs management of any credentialing / enrollment process or procedure roadblocks.
• Provides customers with required paperwork as requested.
• Informs physicians of tasks required to maintain licensure and credentials as appropriate.
• Maintains continuing education credits and informs physicians of deficiencies.
• Maintains software used for credentialing physician information.

• Provides thorough and accurate information to all customers.
• Follows all compliance plan standards.
• Follows all team policies and related procedures.
• Is responsive to customer questions; knows where and how to obtain information/answers.
• Communicates effectively and appropriately maintaining rapport with customers.
• Maintains composure and behaves professionally in difficult customer situations and knows when to involve manager.

• Supports the objectives of the radiologists and Management Team.

• Promotes the practice within the team.
• Cooperates to help other personnel as needed in the spirit of teamwork.

PLEASE NOTE: This is not an exhaustive list of all duties, responsibilities and requirements of the position described above. Other functions may be assigned and management retains the right to add or change duties at any time.

• Must have 3 years experience in Provider Enrollment / Credentialing
• Must possess the ability to initiate and maintain effective Provider records
• Education / Experience: High school diploma or equivalent.
• Skills: Must be able to type and file accurately. Ability to maintain professional judgment. Self-starter. Ability to interact effectively at all levels.
• Physical Requirements: Normal office activity which includes filing, keyboard usage, sitting, stanb ding, walking, writing, locking, dialing a phone, hearing at normal speaking level, talking/speaking clearly over a phone and in person. Lifting of less than 30 pounds is required.
• Intellectual Requirements: Ability to verbally communicate thoughts clearly, do basic math, read, write, file accurately, remember information and be organized.
• Working Conditions: Equal amounts of sitting and standing. Great deal of time spent in front of a computer terminal, on phone and working in files.

Quality Standards

• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism and integrity, and exercise confidentiality in all areas of performance.
• Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.
• Practices universal safety precautions.
• Promotes good public relations on the phone and in person.
• Adapts and is willing to learn new tasks, methods, and systems.
• Reports to work regularly as scheduled; consistently punctual with respect to working hours, meal and rest breaks, and maintains satisfactory personal attendance in accordance with RadNet guidelines.
• Consistently adheres to the time management policies and procedures.
• Completes job responsibilities in a quality and timely manner.

This position often requires sitting, standing, walking, bending, twisting, reaching with hands and arms, using hands and fingers, handling, or feeling, speaking, listening, and high-level cognitive thinking. Must be able to use a computer and other office machinery including copiers, scanners and computer software. Also, must be able to lift up to 10 pounds occasionally. The position requires the ability to drive a vehicle, and utilize other forms of transportation.

Hybrid -office & possible remote setting