MANAGED CARE COORDINATOR
3 weeks ago
Job Location
North Tampa Office - Tampa, FL
Remote Type
Hybrid
Position Type
Full Time
Education Level
High School
Travel Percentage
None
Job Shift
Day
Description
In this role you will:
Be responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical providers who provide patient care at Florida Orthopaedic Institute. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.
Key Responsibilities:
- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Sets up and maintains provider information in online credentialing databases (CAQH) and system.
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies and other entities.
- Processes applications for hospital appointment and reappointment of privileges.
- Tracks license, DEA and professional liability expirations.
- Audits health plan directories for current and accurate provider information.
- Ability to practice a high degree of confidentiality.
- Ability to practice tact and diplomacy, efficiency and organization within the scope of the position.
- Performs other duties as assigned.
- Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute
- All other duties as assigned.
About You
- High School diploma or equivalent.
- Professional and effective oral and written communication skills.
- Organizational skills; ability to multi-task and manage priorities; meet critical deadlines.
- Proficient in Microsoft Excel, Outlook and Word and proprietary database applications.
- A thorough knowledge of all aspects of the credentialing process to include standards, policies and procedures, as well as legal issues involved.
- Delegated Credentialing experience
We Would Love It If You Also Had:
- Two years credentialing and provider experience.
- Experience with Credential Stream Credentialing software.
At FOI our goal is to provide our patients with world-class orthopedic care.
Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations.
What we offer:
- Full time opportunities available, with room for career growth and advancement.
- Excellent job security and stability, to promote an optimal work life balance.
- Be part of this dynamic and growing high level Managed Careteam
Qualifications
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