What are the responsibilities and job description for the Credentialing Coordinator position at Health Care Service Corp.?
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Job Summary
This position is responsible for ensuring professional providers applying for initial or ongoing network participation are credentialed or recredentialed in a timely and appropriate manner for presentation to the medical director and/or credentialing committee; ensure documentation for those providers approved for network participation is current at time of the committee determination and ensure sending out committee communications timely. Conduct the ongoing monitoring process monthly to meet NCQA requirements.JOB REQUIREMENTS:
- High school diploma or GED.
- 3 years business experience. A combination of college level education and experience will be considered
- 1 year Credentialing OR Quality audit experience
- Clear and concise interpersonal, verbal and written communication skills to facilitate the learning process; coaching and mentoring skills
- Experience with multi-tasking and adhering to tight timelines.
- PC experience in Windows, Word, Excel, Access, and other business related/associated databases.
- Demonstrated analytical and organizational skills
- Knowledge of Managed Care products, programs, and services.
PREFERRED JOB REQUIREMENTS:
- Knowledge of CAQH, NCQA, URAC, Medicare and Medicaid
- 2 years of college courses in Business or Medical field.
- Project Management experience.
- Previous experience in oversight of credentialing/claims activities.
- Knowledge of Power Point, Visio and Access.
This is a Flex role (3 days in office; 2 days work from home).
Sponsorship is not available.
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HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$39,900.00 - $88,800.00Salary : $39,900 - $88,800
