Credentialing Coordinator

2 weeks ago


New York, United States Tailored Management Full time
Position Details: Credentialing Coordinator
Location: One West 37th Street New York NY 10018
Shift: 8 am -5 pm
Pay Rate: $25.74/hr paid weekly
Start Date: 11/15/2024

Contract Length: Length of assignment: 4 months / possible extension

Job Description
GENERAL FUNCTION
The Credentialing Coordinator serves as one of the main resources to administer the credentialing and re-credentialing activities with the team. Ensures all EyeMed providers meet the credentialing requirements for participation.

MAJOR DUTIES AND 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

BASIC QUALIFICATIONS
•High School Diploma
•2-3 years business experience with healthcare provider credentialing
•Proficient in Microsoft Office Products (Word, Excel, Access)
•Excellent communication skills (written/verbal)
•Ability to work well independently, under pressure and multi-tasking
•Ability to successfully work on multiple projects simultaneously while managing time effectively

PREFERRED QUALIFICATIONS
•Associate or Bachelor's Degree
•Knowledge of credentialing/provider industry
•Demonstrates sense of urgency
•Experience with operating systems such as EDW/Business Objects

There will actually be 5 courses that required for all temporary employees:

3 for Compliance purposes and 2 for HiTrust / Security requirements:

1. General Compliance
2. HIPAA
3. Fraud, Waste, and Abuse
4. Security Essentials
5. Introduction to Phishing

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