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Credentialing Coordinator
3 months ago
Russell Tobin's client, a leading Italian eyewear company are seeking a Credentialing Coordinator to work in New York, NY
The Credentialing Coordinator serves as one of the main resources to administer the credentialing and re-credentialing activities with the team.
Apply Now
Employment Type: Contract/ Hybrid
Location: New York, NY
Pay rate: $20-$24/hr, DOE
Responsibilities:
- *Supports the overall provider credentialing and re-credentialing processes while maintaining standard turn-around times
- *Responsible to ensure the credentialing files and re-credentialing files are started on time and continue in the process according to standards.
- *Monitors participating provider network for credentialing/re-credentialing deficiencies and takes necessary action per the policies and procedures.
- *Terminates providers who do not comply with the credentialing standards.
- *Prepares and executes outbound communications related to the credentialing events.
- *Researches discrepancies related to provider information.
- *Supports the preparation of weekly rosters to present providers for committee approvals/denials
- *Supports credentialing audits by pulling files and preparing the files for presentation to external clients.
- *Obtains missing information from various sources including the provider to ensure provider maintains compliance with EyeMed Network
- *Executes reports to review and make necessary updates to provider information and provide status to management
- *Prepare reports of status on credentialing activities
Requirements:
- High School Diploma
- 2-3 years business experience with healthcare provider credentialing
- Proficient in Microsoft Office Products (Word, Excel, Access)
- Ability to work well independently, under pressure and multi-tasking
- Ability to successfully work on multiple projects simultaneously while managing time effectively
Nice to have:
- Associate or bachelor’s Degree
- Knowledge of credentialing/provider industry
- Demonstrates sense of urgency
- Experience with operating systems such as EDW/Business Objects
- 1-3 years’ experience in healthcare with a focus on credentialing operations.
- A clear understanding and ongoing knowledge of changes in the Managed Vision Care industry including credentialing, eligibility checking, claims filing and payment receipt.
- Strong organizational skills, and time management.
Benefits that Russell Tobin offers:
Russell Tobin 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.
