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Credentialing Coordinator

3 months ago

Watsonville, California, United States Salud Para La Gente Full time


Job TypeFull-timeDescriptionSalud Para La Gente (SALUD) provides high quality, comprehensive and cost-effective medical, dental, behavioral health, optometry and other services to underserved, low-income communities in the Monterey Bay area, including Santa Cruz and Monterey Counties.

SALUD began in Watsonville in 1978 as a storefront free clinic, and is now a Federally Qualified Health Center (FQHC).

With four health center sites, school-based health centers and over 400 employees, we provide high quality services to patients of all ages.

We offer a competitive salary and benefits package and a collaborative culture that values excellence, achievement, innovation and compassion.

We are seeking an experienced Credentialing Coordinator to provide services to ensure efficient, timely and accurate insurance credentialing and re-credentialing of all healthcare providers.

Under the supervision of the Billing Manager, the Credentialing Coordinator will be responsible for ensuring that all providers have current insurance credentialing.

The ideal candidate will embrace our mission to provide high quality health care to patients of all ages.

This position requires the ability to handle confidential matters with a high level of discretion, process all aspects of insurance credentialing with a high degree of accuracy; meet processing deadlines, use basic math accurately; prepare reports; learn policies and procedures; organize work efficiently, using sound independent judgment; think independently and analytically; use a variety of standard office and computer equipment; communicate effectively and respectfully with a diverse group of people, including organizations doing business with SALUD, demonstrating a knowledge of and sensitivity to their needs; develop and maintain effective working relationships with SALUD staff, health insurance agents, government community agency representatives, and the public.

Responsibilities include, but are not limited to, the following:

Coordinates, organizes and completes provider insurance credentialing and re-credentialing applications, monitors applications and follows up as needed including commercial insurances, Medi-Cal and Medicare.

Coordinates, organizes and completes healthcare facility insurance credentialing and re-credentialing, monitors applications and follows up as needed.
Maintains provider insurance credentialing electronic and hard files.
Maintains knowledge of current health plan and agency requirements for credentialing providers.
Organizes and maintains provider information in online credentialing databases and system.
Ensures practice addresses are current with health plans, agencies and other entitles.
Verifies all aspects of credentialing process for healthcare providers and health care facilities.
Maintains confidentiality of provider information.
Enrolls and maintains SALUD practice locations with health plans.
Ensures all credentialing for both health providers and healthcare facilities are timely.
Optimizes current credentialing workflows.
Maintains knowledge of current health plan and agency requirements for credentialing providers.
Performs other duties as assigned.

RequirementsMINIMUM QUALIFICATIONS Associates Degree or 2 years of educational training post high school or equivalent experienceTwo years health insurance billing, or related, experienceExcellent verbal and written communication skillsAbility to research and analyze dataExcellent attention to detailProficient with Microsoft programs, including Word and Excel and internet resourcesStrong project management skills, including the ability to multi-task and prioritizeAbility to work efficiently, independently and with minimal directionAbility to organize and prioritize work and manage multiple prioritiesDESIREABLE QUALIFICATIONSBilingual in Spanish and bicultural preferredSALARY & BENEFITS $ $34.69 per hour.

Competitive salary and benefits package. Benefits include medical, dental, vision, life insurance, 401(k), Holiday pay and PTO.

Benefit:

Holiday Pay and CA Sick Pay, prorated per hours workedPHYSICAL REQUIREMENTS This position requires full range of body motion, standing, walking, sitting, typing, reaching, bending, moving and/or lifting up to 25 pounds.

Extensive computer keyboarding useAbility to sit for prolonged periods of time.
Salud is an affirmative action and equal opportunity employer.

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

Salud is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

To request reasonable accommodation, contact the Salud Human Resources Department, [ , and ].Salary Description$ $34.69