Credentialing Coordinator

1 month ago

New York, United States Russell Tobin Full time

Russell Tobin & Associates is currently seeking a Credentialing Coordinator to work for our client in the eyewear industry. Apply now for consideration

Contract

Location: New York, NY

Pay Range: 24-28/hr depending on experience

Responsibilities:

  • Support the overall provider credentialing and re-credentialing processes while maintaining standard turn-around times.
  • Ensure credentialing and re-credentialing files are initiated on time and progress according to standards.
  • Monitor the participating provider network for credentialing/re-credentialing deficiencies and take necessary action per policies and procedures.
  • Terminate providers who do not comply with credentialing standards.
  • Prepare and execute outbound communications related to credentialing events.
  • Research discrepancies related to provider information.
  • Support the preparation of weekly rosters to present providers for committee approvals/denials.
  • Support credentialing audits by pulling files and preparing them for presentation to external clients.
  • Obtain missing information from various sources to ensure providers maintain compliance with network standards.
  • Execute reports to review and update provider information and provide status updates to management.
  • Prepare reports on the status of credentialing activities.

Basic Qualifications

  • High School Diploma
  • 2-3 years of business experience in healthcare provider credentialing
  • Proficiency in Microsoft Office products (Word, Excel, Access)
  • Excellent written and verbal communication skills
  • Ability to work independently, under pressure, and handle multiple tasks effectively
  • Capability to manage multiple projects simultaneously while managing time efficiently

Preferred Qualifications

  • Associate or Bachelor’s Degree
  • Understanding of the credentialing/provider industry
  • Demonstrated sense of urgency in task completion
  • Experience with operating systems such as EDW/Business Objects

Russell Tobin / Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.

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