Credentialing Coordinator

Overview

Pay: $21.00/hr on W2

# of Opening: 7

Start time: 6:30am to 9:00am post training

This position is responsible for the analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes. This position is responsible for contracting, credentialing and maintaining Facility / Professional provider data to support marketing, network contracting across all lines of business. This role involves supporting the implementation of special projects, assisting with tracking of various phases of a project and managing workflow.

• HS Diploma/GED (education verification required) plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.
• Written and verbal communication skills including interpersonal skills.
• Skills to develop training materials and act as an advisor to staff
• Experience and proficiency in Microsoft Office software products including analytical tools. Experience developing reports.

• Bachelor Degree-Subject Matter Expert for the Professional Provider Credentialing Process
• 2 years of experience with current government sponsored health insurance networks
• Knowledge of health care delivery systems, claim costing analytics, and provider network adequacy analytics