Company: CAN Community Health
Posted on: January 15, 2023
CAN Community Health, one of the nation's largest providers of HIV
Services, has an exciting opportunity for a Credentialing
Coordinator located at our corporate headquarters in Sarasota, FL.
This position is a hybrid on-site and or work from home
opportunity. Experience preferred but will train qualified
We are looking for someone who is passionate about serving the
needs of individuals impacted by HIV and other infectious diseases.
You will become part of our professional team that drives home our
Company's Mission and Values. We offer good quality of life with an
excellent schedule, competitive pay with a bonus plan, premiere
benefits package with a retirement plan with a generous company
matching contribution. We have received recognition in 2022, 2021,
2019, & 2018 NPT's Best Non-Profit to Work for Award.
CAN is a Drug-Free Workplace. All potential hires will be required
to take and clear a pre-employment drug screen upon job offer.
Proof of COVID-19 Vaccination is preferred for this position.
Salary Range: $21 to $24/hour based upon education level,
background, and experience.
You can find out more about us by visiting our website at
www.cancommunityhealth.org. Apply Today!
Statement of Purpose: This position provides primary support to the
Credentialing Supervisor and Revenue Cycle Management in all
aspects of credentialing, re-credentialing, and contract management
relative to CAN physicians, The Credentialing Coordinator will work
directly with the CAN leadership to facilitate the credentialing,
managed care enrollment, and any demographic changes for physicians
and ancillary providers within the Clinical Group Practice. This
individual may interact daily with physicians, practice
administrators, billing vendors, commercial, and governmental
health plans, and credentialing vendors. The coordinator is
responsible for ensuring that accurate demographic information is
submitted for health plan linkages and all credentialing related
information is shared with all necessary stakeholders in an
expeditious manner. Ensures interpretation and compliance with the
appropriate accrediting and regulatory agencies, while developing
and maintaining a working knowledge of the statues and laws
relating to credentialing.
Primary Tasks: Credentialing Coordinator
1. Updating Provider demographic data in credentialing system.
2. Work with the department leadership to proactively identify
providers who will be joining the clinical group practice and
establish appropriate service and billing information required for
credentialing and payer enrollment.
3. Coordinate the submission of credentialing documents and
demographic information to external vendor to initiate the
credentialing and enrollment of providers into governmental and
commercial health plans.
4. Communicate any possible barriers and delays in credentialing
process to all necessary parties in a timely fashion.
5. Track and monitor the end-to-end enrollment process of providers
from the preparation of contracts to the end point of successful
confirmation of linkage to payers.
6. Prepare and distribute weekly updates of any new provider
enrollments and demographic updates.
7. Correspond with health plans as needed to ensure the appropriate
contract linkage on behalf of CAN providers.
8. Other task and projects as assigned, which support the
credentialing and contract management business needs of the CAN
clinical group practice.
9. Completing and submitting credentialing applications to managed
care insurance companies, governmental plans (CMS Medicare PECOS &
10. Assist clinical providers with CAQH applications on behalf of
CAN employed providers.
11.Processes provider credentialing applications in accordance with
accreditation standards, regulatory requirements, and policies and
12. Conducts thorough background investigation, research and
primary source verification of all components of the application
13. Identifies issues that require additional investigation and
evaluation, validates discrepancies and insures appropriate
14. Responds to inquiries from other healthcare organizations,
interfaces with internal and external customers on day-to-day
credentialing and privileging issues as they arise.
15. Maintains copies of current state licenses, DEA certificates,
malpractice coverage, and any other required credentialing
documents for all providers.
16. Tracks license and certification expirations for all providers
to ensure timely renewals.
17. Promotes and practices CAN Community Health's mission and
values and follows its policies and procedures.
18. Ensures confidentiality is maintained by CM team regarding
patient/client information in accordance with HIPAA, professional
and departmental standards.
Secondary Tasks: Credentialing Coordinator
1. Sets up and maintains provider information in online
credentialing databases and system.
2. Maintains corporate provider contract files.
3. Perform all other duties as assigned.
Responsible To: Credentialing Supervisor
Education/Professional: Credentialing Coordinator
1. High School Diploma; Associate degree preferred.
2. 3- years or more Credentialing experience preferred.
3. Certified Provider Credentialing Specialist (CPCS) preferred or
willing to obtain within 6-months of employment.
Knowledge, Skills and Abilities Required: Credentialing
1. Proficiency in the use of Microsoft Office applications and
2. Communicates effectively both orally and in writing.
3. Ability to analyze, interpret, and draw inferences from research
findings, and prepare reports.
4. Ability to use independent judgement to manage and impart
5. Excellent attention to detail.
6. Ability to establish and maintain effective working
relationships with providers, management, staff, and contacts
outside the organization.
Physical Requirements: Credentialing Coordinator
1. Neat, professional appearance.
2. SEDENTARY- Exerts up to 10 lbs. of force occasionally and/or a
negligible amount of force frequently or constantly in lift, carry,
push, pull, or otherwise move objects, including the human body.
Involves sitting most of the time but may involve walking or
standing for brief periods of time.
3. Requires expressing or exchanging ideas by means of spoken word,
visual and auditory acuity.
CAN is an equal opportunity employer that is committed to diversity
and values the ways in which we are different. All qualified
applicants will receive consideration for employment without regard
to race, color, religion, sex, sexual orientation, gender identity,
national origin, disability, veteran status, or other
characteristic protected by applicable law
Keywords: CAN Community Health, Sarasota , Credentialing Coordinator, Other , Sarasota, Florida
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