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Saint Francis Healthcare System · 4 months ago

Assistant Coordinator of Payer Credentialing

Cape Girardeau, MO

Full-time

Onsite

Entry, Mid Level

2+ years exp

Saint Francis Healthcare System is responsible for providing high-quality healthcare services, and they are seeking an Assistant Coordinator of Payer Credentialing. This role involves managing the credentialing and re-credentialing processes for hospital and provider practices, ensuring compliance with health plans and maintaining accurate data in credentialing databases.

Health CareMedicalNon ProfitPrimary and Urgent CareWellness

Growth Opportunities

Responsibilities

Responsible for all aspects of credentialing and re-credentialing of hospital, all physician practices, and providers for Saint Francis Healthcare System

Responsible for ensuring providers are credentialed, appointed, and privileged with health plans accurately and timely

Maintains data in credentialing database and online systems

Ensure timely renewal of licenses, certification, and validations

This position reports directly to the Medical Staff Coordinator but will have a matrixed reporting relationship to revenue cycle leadership

Compiles and maintains current and accurate data for hospital and providers

Compiles hospital and provider credentialing and re-credentialing applications; monitors applications and follows-up as needed

Maintains copies of current state licenses, DEA certificates, and other required credentialing documents

Maintains knowledge of current health plans and agency requirements for credentialing inclusive of Rural Health, Medicare, Medicaid and broad range of commercial payers

Sets up and maintains information in online credentialing databases and systems

Tracks license and certification expirations for hospital and all providers to ensure timely renewal, revalidation and re-credentialing

Ensures information remains current with all health plans, agencies and other entities

Works with insurance representatives to maintain accurate provider information in health plan directories

Performs other duties as assigned

Qualification

Payer credentialing experienceMedicare/MedicaidCertified Provider Credentialing SpecialistCommunication skillsProblem solving skillsOrganizational skillsAttention to detailWork independentlyRelationship building

Required

High school graduate/equivalent- required

Two to five years of payer credentialing experience with strong understanding and knowledge of Medicare, Medicaid, commercial payers, hospital & rural health specific requirements- required

Excellent oral and written communication skills to communicate with diverse customer groups, including but not limited to, physicians, practice management and staff, vendors, and payers

Strong problem solving skills and attention to detail

Exceptional organization skills with intensely accurate follow through

Ability to work independently with minimal supervision

Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization