Credentialing Coordinator

1 month ago

New York, United States Russell Tobin & Associates Full time



What are we looking for in our Credentialing Coordinator?

Russell Tobin's client, a leading Italian eyewear company are seeking a Credentialing Coordinator to work in New York, NY

The Credentialing Coordinator serves as one of the main resources to administer the credentialing and re-credentialing activities with the team. 

Apply Now

Employment Type: Contract/ Hybrid

Location: New York, NY

Pay rate: $20-$24/hr, DOE

Responsibilities:

  • *Supports the overall provider credentialing and re-credentialing processes while maintaining standard turn-around times
    *Responsible to ensure the credentialing files and re-credentialing files are started on time and continue in the process according to standards.
    *Monitors participating provider network for credentialing/re-credentialing deficiencies and takes necessary action per the policies and procedures.
    *Terminates providers who do not comply with the credentialing standards.
    *Prepares and executes outbound communications related to the credentialing events.
    *Researches discrepancies related to provider information.
    *Supports the preparation of weekly rosters to present providers for committee approvals/denials
    *Supports credentialing audits by pulling files and preparing the files for presentation to external clients.
    *Obtains missing information from various sources including the provider to ensure provider maintains compliance with EyeMed Network
    *Executes reports to review and make necessary updates to provider information and provide status to management
    *Prepare reports of status on credentialing activities

Requirements:

  • High School Diploma
  • 2-3 years business experience with healthcare provider credentialing
  • Proficient in Microsoft Office Products (Word, Excel, Access)
  • Ability to work well independently, under pressure and multi-tasking
  • Ability to successfully work on multiple projects simultaneously while managing time effectively

Nice to have:

  • Associate or bachelor’s Degree
  • Knowledge of credentialing/provider industry
  • Demonstrates sense of urgency
  • Experience with operating systems such as EDW/Business Objects
  • 1-3 years’ experience in healthcare with a focus on credentialing operations.
  • A clear understanding and ongoing knowledge of changes in the Managed Vision Care industry including credentialing, eligibility checking, claims filing and payment receipt.
  • Strong organizational skills, and time management.

Benefits that Russell Tobin offers:

Russell Tobin offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors. 

#CB

Rate/Salary: $20-$24/hr, DOE

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