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Credentialing Coordinator
3 months ago
Position Overview:
Greater Purpose and Core Values:
Athletico's Greater Purpose is to empower people, inspire hope and transform lives.
We accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury.
This is accomplished through building on our Core Values of one team, understanding our business, recognition, people-focused, accountability, continuous innovation and trust and integrity, which are the foundation for our unique culture.
Position Summary:
Essential Duties and Responsibilities:
- Responsible for credentialing, enrolling, and maintaining approximately 300 providers in assigned state/territory; provides support to team members outside of assigned state/territory, as needed
- Tracks and reports progress in credentialing database and provider files by adding status notes and filing payer correspondence
- Notifies payers of professional and clinical staff updates such as service locations, periodic roster updates, name changes, official notices, etc., on an ongoing basis
- Audits provider rosters upon payer requests
Qualifications:
Education:
High school diploma or equivalent required
Work Experience:
Minimum 1 year of payer enrollment experience required; 2-3 years' experience preferred
- Certification/Licensure: Preferred, but not required
- Knowledge and Technical Skills:
- Knowledge of CAQH/Proview, NPPES/I&A Management System and PECOS preferred
- Knowledge of Medicare's enrollment process, including enrollment forms, preferred
- Proficiency in Microsoft 365 required
- Works effectively both independently and in a team setting
- Ability to manage multiple responsibilities and tasks based on their importance and urgency
- Attention to detail and excellent organizational skills required
Language Skills:
- Ability to read, write and speak English proficiently
Physical Demands:
- The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function._
- Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e., while working at a desk), stoop/kneel/crouch, travel around the office, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding.
- Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus
Work Environment:
- Consistent with a standard office environment, noise level is low with little to no extraordinary environmental factors.
Athletico provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.