Credentialing Coordinator
2 weeks ago
Position Overview
As a Credentialing Coordinator, you will play a vital role in supporting the credentialing process within a remote work environment. This full-time position is essential for ensuring compliance with healthcare regulations and maintaining high standards in practitioner credentialing.
About HealthCHEC
HealthCHEC is dedicated to addressing the healthcare needs of diverse populations, focusing on delivering quality services and support to enhance the well-being of individuals. Our organization prides itself on being a leader in the healthcare sector, committed to innovation and excellence in service delivery.
Key Responsibilities
- Assist in the management of credentialing processes by collecting, tracking, and reviewing necessary documentation to meet compliance standards.
- Maintain accurate and up-to-date files on practitioners, ensuring all certifications are current and valid.
- Develop and nurture professional relationships with healthcare providers and groups to facilitate smooth credentialing operations.
- Serve as a knowledgeable resource for internal teams and external partners, providing guidance on credentialing practices and compliance requirements.
- Champion adherence to corporate audit policies and procedures, addressing escalated issues as they arise.
Your Role Includes
- Supporting the credentialing auditors with the processing of initial and re-credentialing applications, verifying eligibility through comprehensive documentation reviews.
- Collecting data from various sources, including the National Practitioner Data Bank, to ensure thorough and accurate credentialing.
- Educating delegated entities on submission requirements to ensure compliance with CMS and NCQA standards.
- Assisting with credentialing audits and tracking corrective action plans for timely documentation submissions.
- Collecting and reviewing submissions during regulatory audits to ensure compliance with CMS requirements.
- Providing exceptional customer service in line with organizational principles and maintaining confidentiality of sensitive information.
Qualifications
- An Associate's Degree or equivalent experience is required.
- A minimum of 3 years of experience in a healthcare or managed care setting is essential.
- Proficiency in data entry and strong organizational skills are necessary for success in this role.
- Excellent communication skills, both verbal and written, are crucial for effective collaboration.
- Ability to multitask and thrive in a fast-paced environment while maintaining attention to detail.
- Proficiency in MS Office applications is required.
Benefits
- Competitive salary range with opportunities for performance-based bonuses.
- Comprehensive wellness programs and generous paid time off policies.
- Eleven paid holidays annually, plus an additional floating holiday.
- A robust 401(k) retirement savings plan with employer matching contributions.
- Employee recognition programs and tuition reimbursement opportunities.
- A supportive work-life balance to enhance employee satisfaction.
Join us at HealthCHEC, where we are committed to improving the health and well-being of our communities through dedicated service and innovative healthcare solutions.
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