[Hiring] Credentialing Coordinator @NAVISTA

Role Description

The Coordinator, Managed Care, Credentialing is responsible for ensuring an active credentialing/enrollment status with all contracted payors for all groups and providers. This position is also responsible for ensuring that all licensure is updated and active for all groups and providers.

• Document and track all credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities within the credentialing platform.
• Maintain and monitor all licenses and certifications in the credentialing platform to ensure compliance within all regions.
• Participate in training sessions and special projects such as learning new system workflows, completing required training, and adopting updated processes within established timeframes.
• Coordinate provider enrollment activities (including initial enrollments or re-credentialing) for all groups and providers.
• Ensure all facility and provider licenses and certifications are accurate and in good standing at all times.
• Complete all forms and supporting documents required to obtain hospital privileges for physicians, as necessary.
• Ensure that all processing and reporting deadlines are consistently achieved.
• Meet regularly with Credentialing Supervisor and other team members to provide updates on progress and status of credentialing and enrollment matters.
• Perform any other functions as required by management.

Qualifications

• At least three (3) years of experience of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database preferred.
• Specific knowledge of the payer environment and payer issues.
• Ability to work a flexible schedule (including overtime, and weekends), as necessary.
• Excellent customer service and communication skills.
• Ability to work independently and as part of a team.
• Working experience with Excel spreadsheets and Microsoft Word documents.
• College degree or commensurate working experience in healthcare preferred.
• Credentialing database experience (such as IntelliCred, E-Vips, Vistar, Cactus, Symed, etc.) preferred.

Requirements

• Applies acquired job skills and company policies and procedures to complete standard tasks.
• Refers to policies and past practices for guidance.
• Receives general directions on standard work; receives detailed instruction on new assignments.
• Consult with supervisor or senior peers on complex and unusual problems.

Benefits

• Medical, dental and vision coverage.
• Paid time off plan.
• Health savings account (HSA).
• 401k savings plan.
• Access to wages before pay day with myFlexPay.
• Flexible spending accounts (FSAs).
• Short- and long-term disability coverage.
• Work-Life resources.
• Paid parental leave.
• Healthy lifestyle programs.