What are the responsibilities and job description for the Credentialing Coordinator position at MetroPlus Health Plan?
Details
Client Name
Metroplus Health Plan
Job Type
Travel
Offering
Non-Clinical
Profession
Non-Clinical
Specialty
Credentialing Coordinator
Job ID
31032015
Job Title
Credentialing Coordinator (000573)
Weekly Pay
764.0
Shift Details
Shift
Mid - 8x3 - 03PM
Scheduled Hours
Job Order Details
Start Date
03 / 31 / 2025
End Date
05 / 31 / 2025
Duration
9 Week(s)
Job Description
Job Title : Credentialing Coordinator
Job Specialty : Provider Credentialing
Job Duration : 9 months
Shift : Hybrid 9-5
Guaranteed Hours : 40.00
Experience : Previous experience with provider credentialing processes and procedures; knowledge of credentialing policies and procedures preferred.
License : Not applicable
Certifications : Not applicable
Must-Have : Excellent communication and organizational skills; Good computer skills and proficiency with MS Office; Knowledge of CACTUS preferred.
Job Description :
- Maintain communication with credentialing contacts to coordinate the receipt of information required for credentialing, re-credentialing, and updating provider credentialing information.
- Review provider credentialing files for completion and prepare them for presentation to the Credentialing Committee.
- Perform primary source verification in accordance with regulatory guidelines and organizational policies and procedures.
- Conduct data entry and manage provider information in credentialing and other relevant databases.
- Verify state medical boards and Medicare / Medicaid lists for any current sanctions, licensure restrictions, or limitations on the scope of practice for credentialed providers.
- Verify state license registration and DEA registration status for all credentialed providers.
- Generate and distribute monthly provider credentialing updates to appropriate departments and participating facilities and provider groups.
- Respond to requests for credentialing information and provide copies of credentialing files to appropriate departments within the organization.
- Generate and distribute provider rosters to delegated facilities and contracted group practices.
- Perform provider roster reconciliation.
- Create, copy, file, and maintain all relevant documentation in provider credentialing folders.
- Maintain confidentiality of provider credentials by properly filing credentialing folders in respective cabinets in the file rooms.
Client Details
Address
50 Water Street
City
New York City
State
Zip Code
10004
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Salary : $764
