Credentialing Coordinator

Operation/Credentialing Manager at Network ESC A Division of Network Temps, Inc.
TOP NON-PROFIT ORGANIZATION HIRING IMMEDIATELY FOR CREDENTIALING COORDINTOR
Located in Bronx, NY
Qualified candidates please send CV to
Essential Duties and Responsibilities:

• Assist with a variety of credentialing processes and procedures.
• Responsible for administrative work in directing and coordinating the medical staff credentialing function.
• Process the coordination of the appointment and reappointment process for all practitioners including: verifying all relevant information via the primary source; reviewing and analyzing potential issues and concerns; and preparing files for routing to the appropriate medical staff leaders, committees and the governing body. Ensure expired certifications and documents are up to date.
• Facilitate and support credentialing activities with external credentialing consultant vendor and privileging process to ensure compliance with medical staff bylaws and accrediting agencies. This includes the process for verification of licensure, education/training, board certification, current competency, disciplinary actions, sanctions, and malpractice insurance clearance.
• Maintain all credentialing-related databases and track credentialing progress of providers. Follow-up with payers/Consultants regarding provider enrollment status and maintain documentation and reporting regarding the enrollment process.
• Follow up and ensure completion of all credentialing activities until successful completion.
• Collaborate with Revenue Cycle (Billing) to identify and resolve issues/concerns related to payors and network status.
• Serve as primary contact responsible for processing primary source credentialing, collecting required documents and training verifications, monitoring status changes, and advancing crucial workflows with the primary objective of successful and timely recredentialing completion to the highest standard.
• Manage Credentialing Consultant by maintaining necessary logs, lists, reports, records, and current documentation required for physician/provider credentialing and re-credentialing to ensure requirements are met in a timely manner.

Associates degree or related experience.

Credentialing experience required.

• Great attention to detail and exceptional follow-up skills. Must also be a team player, hard-working and have excellent communication skills.
• Experience in a healthcare setting, including provider enrollment and provider network management experience desirable.
• Ability to communicate professionally and effectively in person, on the phone, electronically, or through other means to individuals and groups.
• Ability to maintain complete confidentiality in handling sensitive enrollment issues.
• Proficiency in Microsoft Office, particularly Word, Excel, Outlook.
• Maintain high levels of organization while being extremely focused on details.
• Capable of meeting time-sensitive deadlines for multiple tasks.
• Ability and desire to understand and adhere to complex regulations.
• A can-do attitude. You will roll up your sleeves and do whatever it takes to get the job done.
• Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance preferred.

• Associate

• Full-time

• Human Resources
• Human Resources Services