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Credentialing Coordinator

ICONMA

Role overview

Qualifications

  • 1-3 years of successful work experience in a credentialing role/department
  • Intermediate skills with Google Suites
  • Must be familiar with NCQA accreditation standards
  • High school diploma or up to 1 year of equivalent experience

Responsibilities

  • Ensure clinicians successfully pass the Client credentialing process
  • Assist clinicians with the completion of their credentialing applications
  • Perform primary source verifications and maintain the MD Staff credentialing database
  • Ensure all credentialing functions comply with internal policies and applicable requirements

Key facts

Hard skills

Physician Data Query Google Services Certification Structure Oversight Committee (CSOC)

Other skills

  • Problem Solving
  • Decision Making
  • Active Listening
  • Social Skills
  • Teamwork
  • Organizational Skills

About the company

ICONMA logo

ICONMA

Management Consulting

We provide Professional Staffing Services & Project-Based Solutions for a broad range of Fortune 500 organizations. ICONMA is a certified Woman-Owned staffing company and was founded in 2000. ICONMA’s corporate headquarters is in Troy, Michigan, and has 15+ locations worldwide. What makes ICONMA stand out in a fiercely competitive industry? *We provide integrated, full lifecycle services across a broad range of business and technical platforms. *No single company can duplicate our full range of staffing and permanent recruiting services nationwide. *Proven track record of attracting and retaining exceedingly skilled professional workers in a highly competitive market. SERVICES OFFERED Staff Augmentation (Contract, Contract to Hire, Direct Hire, Single Source) Data Analysis Project-Based Services & Solutions Hire Train Deploy Service Model Offshore Staff Augmentation Payroll Services AREAS OF EXPERTISE - Information Technology - Engineering - Business Professional - Accounting/Finance - Admin/Clerical/Call Center - Healthcare/Clinical/Scientific - Marketing/Creative mail linkedin@iconma.com Phone (888) 451-2519 Website http://www.iconma.com

Company details

Company typeLarge
IndustryManagement Consulting
Company size1001 - 5000

Links

Website LinkedIn See all jobs

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Job description

Our client, a Healthcare company, is looking for a Credentialing Coordinator for their Farmers Branch, TX/ Remote location.
 
Responsibilities:
  • The Credentialing Specialist ensures clinicians successfully pass the Client credentialing process.
  • This role is responsible for assisting clinicians with the completion of their credentialing applications , performing primary source verifications , and maintaining the MD Staff credentialing database.
  • The Specialist must ensure all credentialing functions comply with internal policies, client health plan contracts, URAC guidelines, NCQA standards, and applicable state and federal requirements.
  • This position reports to the Credentialing Supervisor
  • Review and process credentialing and re-credentialing files.
  • Establish and maintain a system for the timely processing of credentialing files in accordance with NCQA policies.
  • Query appropriate organizations and evaluate responses to ensure provider compliance with NCQA standards.
  • Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers.
  • Review all background checks, drug tests, and TB screenings and record the results.
  • Assemble all verified information and prepare files for presentation to the Credentialing Committee.
  • Verify providers’ requirements for approval to work in specific states and plans.
  • Assist with the ongoing monitoring of contracted clinicians.
  • Utilize the MD Staff credentialing database to perform queries, generate reports, and optimize efficiency.
  • Provide administrative support to department leadership and both internal and external stakeholders.
  • Maintain professionalism at all times 17and provide timely, professional responses to all emails.
  • Actively demonstrate teamwork and assist with special projects.
  • Responsible for the security and privacy of any protected health information (PHI) accessed during work activities..
 
Requirements:
  • 1-3 years of successful work experience in a credentialing role/department.
  • Intermediate skills with Google Suites.
  • Must be familiar with NCQA accreditation standards.
  • Demonstrate active listening skills and the ability to provide and receive constructive feedback
  • Strong interpersonal skills, with the ability to build rapport and productive relationships with internal and external stakeholders
  • Obtain NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify.
  • Working knowledge of problem-solving and decision-making skills.
  • Ability to organize and prioritize workload and day-to-day tasks.
  • High school diploma or up to 1 year of equivalent experience.
 
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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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