Medical Insurance Credentialing Specialist

19 hours ago


Kansas City, Missouri, United States St Joseph Medical Group Full time
Overview

At St. Joseph Medical Center, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our community. As a member of Prime Healthcare, St. Joseph Medical Center is actively seeking a skilled Medical Insurance Credentialing Coordinator to join its award-winning team.

With a rich history dating back to 1874, St. Joseph Medical Center has a long tradition of providing exceptional care. Our Catholic heritage and the spirit of our founding Sisters continue to guide our mission of caring for the community. We are proud to be a part of the Diocese of Kansas City-St. Joseph, under the leadership of Bishop James V. Johnston, Jr.

Responsibilities

The Medical Insurance Credentialing Coordinator will be responsible for tracking provider enrollments, re-credentialing, and new contract applications with commercial and government health plans. This role requires strong communication and organizational skills, as well as the ability to effectively manage multiple tasks and deadlines.

  • Perform CAQH maintenance and ensure timely completion of credentialing and enrollment tasks.
  • Effectively communicate the contracting and enrollment process to Regional Directors and other stakeholders.
  • Monitor and maintain websites for pending revalidations and credentialing requests.
Qualifications

To be successful in this role, the ideal candidate will possess:

  • An Associate's degree or equivalent education/experience.
  • Certified Provider Credentialing Specialist (CPCS) certification is preferred.
  • Strong computer, communication, and writing skills.
  • Proficiency in Microsoft Office: Word, Excel, and PowerPoint.
  • A positive attitude and willingness to learn.
  • Knowledge of managed care plans, PECOS, NPPES, and CAQH.


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