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Credentialing Coordinator I

2 months ago

Chandler, Arizona, United States Arizona Priority Care Full time
About the Role

Arizona Priority Care is seeking a highly skilled Credentialing Coordinator I to join our team. As a key member of our healthcare organization, you will play a critical role in ensuring the smooth operation of our credentialing process.

Key Responsibilities
  • Process initial credentialing and recredentialing applications for practitioners in accordance with contracted health plans, regulatory bodies, and NCQA standards.
  • Verify primary sources and enter data into the Morrissey database with a minimum of 10 files per week and a 95% accuracy rate.
  • Contact practitioners' offices for additional information needed for completion of the credentialing process.
  • Process expired primary source verification documents, including state licensure, DEA, COI, and accreditation/board certifications in a timely manner.
  • Manage the credentialing database in Morrissey by making necessary changes to provider demographics.
  • Add providers to CAQH for credentialing and remove when the credentialing process is complete.
  • Provide exceptional customer service and assist practitioners as needed with the credentialing process.
  • Maintain current knowledge of CMS and NCQA Standards, and AZPC Credentialing, Plan, policies, and procedures.
  • Protect practitioners' privacy and ensure information is kept confidential.
Requirements
  • High school diploma or GED required.
  • Minimum of 1-year administrative healthcare-related experience required.
  • Minimum of 2 years of credentialing/re-credentialing experience preferred.
  • Knowledge of Morrissey credentialing software system preferred.
  • Working knowledge of computer applications, such as Microsoft Office (Word and Excel).
  • Excellent written and verbal communication skills.
  • Demonstrate ability to be detail-oriented and multi-task effectively.