Provider Credentialing Coordinator

4 weeks ago

Orlando, Florida, United States InHealth MD Alliance LLC Full time
Position Overview

InHealth MD Alliance LLC is in search of a dedicated full-time Provider Credentialing Coordinator to manage the processing of healthcare provider applications and maintain communication regarding credentialing updates. This role involves ensuring compliance with established organizational protocols and current industry standards in credentialing.

As a forward-thinking organization, InHealth MD Alliance LLC is committed to delivering exceptional primary care services, with a focus on the health and wellness of our patients. We pride ourselves on our extensive network and the quality of care provided by our skilled professionals. Our team is our greatest asset, and we offer competitive compensation, comprehensive benefits, and a supportive work environment.

BENEFITS OF JOINING OUR TEAM:

  • Affordable medical, dental, and vision insurance effective the first day of the month following your start date
  • Employer-sponsored life insurance
  • Optional short-term disability and life insurance
  • Voluntary accident and illness insurance
  • 401K retirement savings plan
  • Health Care Flexible Spending Account (FSA)
  • Generous paid time off
  • Floating holidays and federal paid holidays
  • Paid bereavement leave
  • Employee assistance program (EAP)
  • Additional perks and discounts

KEY RESPONSIBILITIES:

  • Conduct initial credentialing and re-credentialing processes for all healthcare practitioners.
  • Ensure accurate and timely data entry, regularly updating practitioner information in the credentialing database; maintain both paper and electronic records.
  • Utilize various data systems, including CAQH, NPPES, PECOS, and others, to manage practitioner data submissions as required by health plans.
  • Facilitate the enrollment of practitioners with all contracted health plans and monitor their progress.
  • Verify that all practitioners maintain current malpractice insurance.
  • Track expiring licenses, certifications, and other essential documents, assisting practitioners with timely renewals.
  • Perform sanctions and compliance monitoring, promptly notifying management of any negative findings.
  • Assist practitioners in obtaining new state licenses as needed, tracking their progress throughout the process.
  • Adhere to established policies and procedures, ensuring timely completion of tasks and efficient resource utilization.
  • Identify and resolve discrepancies or issues that may hinder the credentialing process, reporting significant problems to management.
  • Coordinate all necessary background checks and registrations as required by regulatory agencies.
  • Maintain up-to-date Medicare and Medicaid credentialing for all practitioners.
  • Ensure proper setup of electronic medical records and prescribing licenses for new practitioners.
  • Support the designation of clinics and assist physicians in transferring their licenses as needed.
  • Perform additional duties as assigned by management.

QUALIFICATIONS:

  • High school diploma or equivalent required; a bachelor's degree in healthcare administration is preferred.
  • 3-5 years of experience in healthcare credentialing.
  • Certification from the National Association of Medical Staff (NAMS) is highly desirable.
  • Proficient computer skills are essential.

JOIN OUR TEAM:

We value your time and have streamlined our application process for your convenience. If you believe you are a suitable candidate for this role, we encourage you to complete our brief application form for consideration. We look forward to the opportunity to connect with you.

InHealth MD Alliance LLC is an Equal Opportunity Employer (EOE) and adheres to all applicable federal, state, and local anti-discrimination laws.

We maintain a drug-free workplace in compliance with relevant federal and state regulations.

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