Duties: The Credentialing Coordinator is responsible for processing and completing the credentialing and recredentialing functions of all providers by NCQA state and federal requirements. Principal Accountabilities: Validates completeness of provider applications before processing. Conducts primary source verification for all credentialing and recredentialing applications. Monitors the progress and completion of all site visits by the provider network team to ensure completion within the established timeframe. Accurately enters all critical data elements of provider applications into the Credentialing system. Respond to phone inquiries received in the Credentialing phone queue from internal and external clients. Completes projects as assigned.
Skills: Intermediate knowledge of PC applications including Microsoft Office. Strong verbal and written communication skills. Strong organizational skills are required. Ability to perform in a metricsdriven environment.
Education: High School/GED with 4 years of experience. OR Associates Degree with 1 to 2 years of experience. OR Bachelors Degree with 0 to 1 years of experience. 0 to 4 years of prior provider credentialing experience based on a combination of education and experience.
Required Skills: ORGANIZATIONAL SKILLSMETRICSMICROSOFT OFFICEQUEUE MANAGEMENT
Hours Per Day: 8.00
Hours Per Week: 40.00
Languages: English( Speak Read Write )
Department: AMHSS: Provider Enrollment Svc Growth
Job Category: NonClinical Admin/Claims/CSR/Tech