Credentialing Coordinator

Credentialing Coordinator needed for large hospital system. 8-12 weeks CONTRACT position. 

Hybrid!

$25-$26./hr

40 hours a week

Job Responsibilities

• Coordinates with over 550 clinicians to update and maintain PECOS and CAQH to ensure accuracy of data to maintain payer credentials and re-credentialing for the ability to maintain billing for services rendered to patients.
• Coordinates and works directly with the clinicians and practice managers for attestation of information in the CAQH system, which is required every 90 days.
• Maintains all data in the system.
• Responsible for maintaining all practice location information for ADA compliance for all payers per their request, as well as the CAQH file.
• Manages the Payer Credentialing documents folder to ensure all documents for credentialing are uploaded and maintained.
• Works with practice manager and/or provider to facilitate the gathering of documents for timely processing into the CAQH system.
• Coordinates all quarterly payers audits to ensure accurate roster information is maintained in the payer directories, via spreadsheets and faxed information received.
• Client's contact for payer's phone calls, emails and faxed requests (demographic calls, ADA forms, demographic information faxes from the payers.
• Works with all clinicians to set up PECOS and CAQH accounts as well as establish clinician NPI's.
• Participates frequently in all project related function in department and assists other team members as required.

Required Experience:

• 2-3 years progressively responsible experience in payer credentialing, and/or physician billing experience
• Mid level Excel knowledge
• Demonstrates accurate knowledge of payer credentialing guidelines
• Experience in utilizing CAQH, NPI and PECOS websites. A PLUS!
• Excellent communication (verbal, written) and organizational skills.
• Able to work independently.
• Attention to detail and accuracy is vital
• Ability to work under pressure for a demanding clientele (physicians).
• Excellent customer service skills.
• Flexibility in order to assist or cover for other team members as required.

Required Education:

• High School graduate.
• Associates Degree preferred

Training / Certification / Licensures:

• National Committee of Quality Assurance Certification (NCQA) preferred. A PLUS