Credentialing Coordinator
Company: CAN Community Health
Location: Sarasota
Posted on: January 19, 2023
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Job Description:
Description:
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
candidates. 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 & Florida
Medicaid). 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 procedures.
12. Conducts thorough background investigation, research and
primary source verification of all components of the application
file. 13. Identifies issues that require additional investigation
and evaluation, validates discrepancies and insures appropriate
follow-up. 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
Requirements:
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 Coordinator 1. Proficiency in the use of
Microsoft Office applications and internet resources. 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 confidential information. 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 PI200398651
Keywords: CAN Community Health, Sarasota , Credentialing Coordinator, Other , Sarasota, Florida
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