2 Credential and Managed Care Coordinator Jobs in Norfolk, VA

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Credential and Managed Care Coordinator

Virginia Oncology Associates

Norfolk, VA | Full Time

$42k-61k (estimate)

1 Month Ago

Managed Care Coordinator - Foster Care

The Elevance Health Companies, Inc.

NORFOLK, VA | Other

$67k-88k (estimate)

3 Weeks Ago

Credential and Managed Care Coordinator

$42k-61k (estimate)

Full Time 1 Month Ago

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Virginia Oncology Associates is Hiring a Credential and Managed Care Coordinator Near Norfolk, VA

Overview:
Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Credentialing Managed Care Coordinator for our office in Norfolk.
***Please take this quick survey once you've submitted your resume to complete the application process: Credential and Managed Care PI Survey
Responsibilities:

Credentials and re-credentials providers according to quality standards and company policies and procedures. Notifies providers of licensure expirations and submits licensure applications and renewal forms with payment to State agencies and appropriate departments. Recommends process improvements.
Maintains current provider licensure files and provides information to hospitals and other healthcare providers as appropriate. Requests and completes hospital credentialing and privileges applications for providers.
Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office.
May implement and maintain the contract management system to include terms of the contract, providers credentialed to the payer and other contracted service providers (labs, hospitals).
May complete EOB analyses or fee schedule variance reporting on a monthly basis for the top Managed Care payers according to policy and procedure. May produce monthly managed care reports and implement new analysis tools to assist in reporting functions.
May maintain expected reimbursement by CPT code for the top payer contracts in each market and communicate changes to system librarian.
May develop and provide maintenance of proformas for all contracts.
Supports Network Contracting Representative/Manager in general administrative functions.
Trains junior and practice staff with respect to credentialing contracts, policies and procedures.
Other duties as requested or assigned.

Qualifications:

High school diploma or equivalent required.
Technical certification or Associates Degree a plus.
At least five (5) years of credentialing related work experience required.
Proficiency with computer systems and Microsoft (Office Outlook, Word, Power Point, and Excel) required.
CPCS certification is preferred.