Provider Credentialing Coordinator

2 weeks ago

Cornelius, Oregon, United States HEALTH NETWORK SOLUTIONS INC Full time
Job Overview

About Health Network Solutions Inc:

We are a privately-owned physician network dedicated to enhancing healthcare accessibility and effectiveness. Our organization thrives in a dynamic managed care environment, fostering a family-oriented culture that makes our work both challenging and enjoyable. We pride ourselves on offering competitive compensation and a comprehensive benefits package, while maintaining a standard 37-hour workweek.

Position Summary:

The Provider Credentialing Coordinator is responsible for overseeing and executing various tasks essential for processing credentialing applications for new and existing network providers. Collaborating closely with the Director of Credentialing, you will engage in a series of activities aimed at evaluating and determining the eligibility of providers to join or continue in our network. This role adheres to established company policies and procedures to ensure compliance with relevant laws, regulations, and industry standards.

Key Responsibilities:

  • Distributes credentialing and recredentialing application packets to providers.
  • Verifies that received application packets are complete and contain all necessary information.
  • Informs applicants of important deadlines and timelines.
  • Maintains electronic logs to track application progress and compliance with deadlines.
  • Creates and maintains files for all credentialing applicants and recredentialing documentation for current network providers.
  • Conducts credentialing activities within strict timelines.
  • Stays informed about current payer, agency, and third-party credentialing requirements, including NCQA, URAC, and CMS standards.
  • Reviews credentialing files to ensure compliance with NCQA, URAC, CMS, and company standards.
  • Performs primary source verification as mandated by relevant standards and payer requirements.
  • Communicates with providers to gather any missing or incomplete information.
  • Inputs provider data into the electronic records system according to established protocols.
  • Completes verification checklists to document credentialing tasks and timelines.
  • Prepares documentation for review by the Credentialing Committee.
  • Notifies providers regarding credentialing outcomes.
  • Ensures that the credentialing process is conducted fairly and without discrimination.
  • Maintains confidentiality of all information gathered during the credentialing process.
  • Demonstrates knowledge of current health plan information and agency credentialing requirements.
  • Adheres to the standards of the Health Insurance Portability and Accountability Act (HIPAA) to protect personal and confidential information.
  • Understands and complies with Health Network Solutions program requirements.
  • Performs additional duties as assigned.

Qualifications:

  • High School Diploma or GED is required.
  • A Bachelor's degree in Business, Healthcare Administration, Communications, or a related field is preferred; however, equivalent work experience may be considered.
  • 1-2 years of prior experience in credentialing healthcare providers within a hospital, provider network, or payer environment.

Skills and Competencies:

  • Exceptional customer service and interpersonal skills.
  • Strong communication skills, both verbal and written, to effectively interact with providers and colleagues.
  • Excellent organizational and time management abilities.
  • Capacity to make informed decisions based on organizational goals and constraints.
  • Detail-oriented with strong critical thinking skills to assess provider application data.
  • Ability to handle sensitive situations with professionalism and diplomacy.
  • Experience working with diverse populations.
  • Commitment to maintaining confidentiality and adhering to compliance policies.
  • Proficient in multitasking, prioritizing, and meeting deadlines.
  • Basic computer skills, including proficiency in MS Office applications.

Employment Type: Full-time

Benefits:

We provide a comprehensive benefits package, including paid medical, dental, and vision coverage; paid holidays and time off; a 401k plan with company matching; a standard 37-hour workweek; and a supportive work environment.

  • Print Project Coordinator

    4 days ago

    Cornelius, Oregon, United States AlphaGraphics Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Print Project Coordinator to join our team at AlphaGraphics Lake Norman. As a key member of our marketing communications team, you will be responsible for providing exceptional customer service and ensuring the smooth execution of print projects.Key ResponsibilitiesProvide timely and accurate...

  • Sales and Human Resources Coordinator

    3 weeks ago

    Cornelius, Oregon, United States The Higher Taste Ltd Full time

    Job OverviewHigher Taste is a well-established, family-operated food production company dedicated to crafting high-quality Vegan and Vegetarian products. We are currently looking for a committed individual to fill the role of Sales and Human Resources Coordinator. This position offers a full-time work schedule, opportunities for career advancement, and...

  • Licensed Clinical Psychologist

    5 days ago

    Cornelius, Oregon, United States LifeStance Health Full time

    About LifeStance HealthLifeStance Health is a national provider of mental healthcare services focused on evidenced-based, medically driven treatment services for children, adolescents and adults suffering from a variety of mental health issues in an outpatient care setting, both in-person at its clinics nationwide and through its digital health telemedicine...

  • Office Coordinator

    2 weeks ago

    Cornelius, Oregon, United States Be Coaching and Consulting, LLC Full time

    Job OverviewThe successful candidate will demonstrate outstanding communication abilities, possess the capacity to follow guidance, and effectively manage daily responsibilities and projects. A strong aptitude for collaborating within a predominantly remote team and adhering to strict deadlines will be crucial for excelling in this position.The following...

  • Senior Fitness Program Coordinator

    3 weeks ago

    Cornelius, Oregon, United States Burn Boot Camp Full time

    BURN BOOT CAMP CULTURE Burn Boot Camp stands as one of the most rapidly expanding fitness franchises in the country, having experienced significant growth since its inception. Our movement mirrors that of our members—intentional and energetic. We strive to inspire, empower, and transform lives through community-oriented fitness initiatives. POSITION...

  • Diagnostic Cardiac Sonographer

    18 hours ago

    Cornelius, Oregon, United States Kaiser Permanente Full time

    Job SummaryKaiser Permanente is seeking a skilled Cardiac Sonographer to provide diagnostic services in a hospital and/or clinical setting.Key ResponsibilitiesPerform diagnostic procedures, including routine, emergent, portable, and surgical examinations, in accordance with department policies and procedures.Communicate effectively with cardiologists and...

  • Dentist Opportunity in Cornelius, NC

    1 day ago

    Cornelius, Oregon, United States Heartland Dental Full time

    About the RoleWe are seeking a skilled General Dentist to join our team at Heartland Dental in Cornelius, NC. As a leader in our supported office, you will have the autonomy to provide exceptional patient care while benefiting from our comprehensive support system.What You'll GainUnlimited PTO and paid holidaysCompetitive benefits, including health insurance...

  • Licensed Mental Health Therapist

    4 days ago

    Cornelius, Oregon, United States LifeStance Health Full time

    About the RoleWe are seeking a highly skilled Licensed Mental Health Therapist to join our clinical team at LifeStance Health. As a key member of our team, you will be responsible for providing high-quality behavioral healthcare services to our patients.Key ResponsibilitiesProvide individual and group therapy sessions to patients of all agesDevelop and...

  • Clinical Psychologist

    5 days ago

    Cornelius, Oregon, United States LifeStance Health Full time

    About LifeStance HealthWe're a national provider of mental healthcare services focused on evidence-based, medically driven treatment services for children, adolescents, and adults suffering from a variety of mental health issues in an outpatient care setting, both in-person at our clinics nationwide and through our digital health telemedicine offering.Our...

  • Operations Manager

    2 weeks ago

    Cornelius, Oregon, United States Talent Launch - Alliance Industrial Full time

    Job OverviewTalent Launch - Alliance Industrial is seeking a highly skilled General Manager to oversee and coordinate the activities of our team.Key Responsibilities:Supervise and lead a team of professionalsDevelop and implement daily schedules for shift personnelProvide training and evaluate employee performanceTrack and analyze monthly results and trends...

  • Executive Director

    2 weeks ago

    Cornelius, Oregon, United States Talent Launch - Alliance Industrial Full time

    Job OverviewTalent Launch - Alliance Industrial is seeking a highly skilled General Manager to oversee and coordinate the activities of our team.Key Responsibilities:Supervise and lead a team of professionals to achieve business objectives.Develop and implement daily schedules for shift personnel to ensure optimal productivity.Provide training and evaluation...

  • SR. Administrative Assistant

    2 months ago

    Cornelius, Oregon, United States Community Action Organization Full time

    Position Summary:In support of the Agency's mission, this position is responsible for providing specialized administrative support for the assigned Director while maintaining a high degree of confidentiality. This position plays a key role in supporting the day-to-day operations of the assigned in support of the assigned Director and is the central point of...

  • Annuity Product Specialist

    7 days ago

    Cornelius, Oregon, United States Financial Independence Group, LLC Full time

    Job SummaryFinancial Independence Group, LLC is seeking a highly motivated and results-driven Annuity Product Specialist to join our team. As an Annuity Product Specialist, you will be responsible for communicating with financial professionals to wholesale annuity products from leading carriers through our organization.Key ResponsibilitiesDevelop and...

  • Civil Engineering Designer

    16 hours ago

    Cornelius, Oregon, United States Cyfle Full time

    About the JobCyfle is seeking a skilled Civil Engineering Designer to join our team in Cornelius, NC. As a key member of our engineering design and consulting firm, you will be responsible for performing civil site/land development design, permitting, and construction observation on various residential, commercial, and institutional projects.Key...

  • CT Technologist

    1 week ago

    Cornelius, Oregon, United States Kaiser Permanente Full time

    Job SummaryKaiser Permanente is seeking a skilled CT Technologist to join our team in a dynamic and patient-centered environment.Key ResponsibilitiesOperate CT scanners and other radiographic equipment to produce high-quality diagnostic images, ensuring optimal patient care and safety.Perform diagnostic procedures, including routine, emergent, biopsy, and...

  • Gas Station Attendant

    4 days ago

    Cornelius, Oregon, United States Cain Petroleum Full time

    About the RoleWe are seeking a highly motivated and customer-focused individual to join our team as a Gas Station Attendant at Cain Petroleum. As a key member of our team, you will be responsible for providing exceptional customer service while fueling vehicles with requested fuel grades.Key ResponsibilitiesGreets customers, answers questions, and provides...

  • CT Technologist

    3 days ago

    Cornelius, Oregon, United States Kaiser Permanente Full time

    Job SummaryKaiser Permanente is seeking a skilled CT Technologist to join our team in a dynamic and patient-centered environment.Key ResponsibilitiesOperate CT scanners and other radiographic equipment to produce high-quality diagnostic images, ensuring optimal patient care and safety.Perform diagnostic procedures, including routine, emergent, biopsy, and...

  • Overhead Distribution A Lineperson

    4 weeks ago

    Cornelius, Oregon, United States Utilities Service, LLC Full time

    Overhead Distribution A Lineperson A line worker installs and fixes overhead distribution and transmission systems, which include poles, cables, and electrical systems. Line Workers also fit, repair, and maintain underground cables and electrical equipment. Pay : Competitive/Hourly Benefits : Health/Dental/Vision Insurance Short/Long Term Disability ...

  • Business Development Representative

    2 weeks ago

    Cornelius, Oregon, United States Burn Boot Camp Full time

    About Burn Media Co.Burn Media Co. is a dynamic and innovative digital marketing agency dedicated to helping businesses succeed in the digital landscape.Job OverviewWe are seeking a highly motivated and talented Business Development Representative to join our team and drive business growth by prospecting new clients, nurturing relationships, and closing...

  • Mobile Calibration Technician

    2 weeks ago

    Cornelius, Oregon, United States Trescal Inc Full time

    Job OverviewTrescal Inc is a dynamic organization seeking skilled individuals to enhance our team. As a leading independent provider of calibration, repair, and asset management services in the U.S., we pride ourselves on delivering exceptional solutions to our clients.Position: Traveling Logistics/Driver with Technical ExpertiseThis full-time role involves...