Job Description
Soni's Client is seeking an organized and detail-oriented Credentialing Coordinator for a rapidly growing practice. You will be responsible for the effective, accurate and timely management of care credentialing for all clinicians (i.e., licensed independent practitioners and allied health practitioners) in accordance with federal, state and department procedures. Responsibilities: Completing and processing provider credentialing applications Maintaining current and accurate credentialing/privileging files for all licensed independent practitioners Maintaining knowledge of current health plan and agency requirements for credentialing providers Providing credentialing and privileging verifications if applicable Notifying managed care plans of all terminations and demographic changes for all licensed individual practitioners (LIPs) Auditing managed care plans on a monthly basis to ensure that all LIPs are accurately enrolled with all appropriate practice locations Complying and maintaining accurate monthly reports/rosters of all enrolled/credentialed practitioners; confirming all providers are appropriately enrolled with the correct managed care plans Responding to inquiries from other healthcare organizations, interfacing with internal and external customers on day-to-day credentialing and privileging issues as they arise Assisting with managed care delegated credentialing audits; conducting internal file audits Utilizing the credentialing database, optimizing efficiency and performing query, report and document generation Assisting in the implementation and maintenance of processes and procedures including regulatory certification guidelines related to physician credentialing Qualifications: 1-2 years of current and relevant credentialing experience, knowledge of medical credentialing and privileging procedures and standards Ability to efficiently and effectively manage multiple tasks to prioritize needs and meet deadlines Strong attention to detail Sound written and verbal communication skills Ability to maintain confidentiality of information and exercise good judgment and discretion in handling and disseminating information Ability to research and analyze data and to work independently with minimal supervision Compensation: $24-$26/ Hour Salary is based on a range of factors that include relevant experience, knowledge, skills, and other job-related qualifications. J-18808-Ljbffr