The Credentialing Coordinator assists the Credentialing Manager in all aspects related to credentialing and re-credentialing of Select Medical and non-Select Medical practitioners and facilities. Primary duties involve processing and maintaining practitioner credentialing information and performing all associated duties to insure Select Medical’s Credentialing Department operates according to National Committee of Quality Assurance (NCQA) standards.

Responsibilities

Manage state specific credentialing activities.
Prepare and process all credentialing documentation.
Update and maintain current and accurate practitioner files and data base.
Track and report practitioner changes to appropriate parties.
Communicate with practitioners, data banks, state licensing and regulatory bodies, educational programs, health plans, and other divisions within the company.
Coordinate with health plans to provide practitioner credentialing documentation as required.
Participate in activities associated with health plan site audits and Credentialing Committee meetings.
Coordinate training and educational requirements for credentialing staff.
Maintain confidentiality of practitioner information.
Collaborate with team members to assist with process improvement and development of policies and procedures.
Provide routine updates and status reports for health plans and other divisions within the company.
Coordinated efforts with other credentialing and Managed Care personnel.
Troubleshoot with internal business operations and Managed Care contracting to resolve accounts receivable delays due to credentialing issues.
Participate in development and coordination of departmental CQI initiatives. Perform other duties as assigned.

Qualifications

Minimum Requirements:

Minimum of 2 years of experience in the credentialing field or related healthcare field
Proficient in Windows (Word, Excel, and Access)
Ability to be professionally assertive with both internal and external partners to be influential in finding resolutions
Good oral and written communication skills with the ability to interact professionally and positively within all levels of the organization

Preferred Qualifications:

Prior credentialing experience
General knowledge of credentialing processes, terminology and NCQA standards.
Excellent communication skills required.
Strong analytical skills, including process improvement and problem resolution.Must be detail-oriented with good organizational skills and able to maintain accuracy while meeting deadlines and production requirements.
Excellent interpersonal skills and commitment to quality improvement.

Additional Data

Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer. Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law.

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Credentialing Coordinator (CVO)

Job Description

Responsibilities

Qualifications

Additional Data

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Related Details

The Select Medical Family Of Brands