Coordinator, Provider Credentialing - Intermediate, Days

The Coordinator, Provider Credentialing - Intermediate assists where needed for credentialing and re-credentialing, verifying documents, certifications, licensures and education. Verification of malpractice insurance and issuing Certificate of Insurance for NMG providers, Hospitals, and pharmacies each year. Assigns new providers to the associate coordinator or re-assigns existing providers as needed. Supports NMG providers and non-employed providers as needed in processing applications in accordance with regulatory and accreditation requirements in order to maintain active and good standing for the purpose of enrollment with the health plans contracted with the organization. The Coordinator, Provider Credentialing - Intermediate is responsible for following processes including requests for change or updates and follow through skills. Also responsible for the review of credentialing claims returned. Must be competent to work the initial enrollment process but may require instruction and guidance in other areas. Position includes problem management and troubleshooting in order to determine and resolve issues. Assists in determining enrollment needs, helps to investigate solutions, and presents recommendations to senior coordinator and management as needed. Serves as a liaison between all NMG providers, non-employed providers, and contracted health plans. Must possess the ability to guide and advise less experience coordinators. Establish and maintain effective working relationships with providers, Senior Coordinators, Leadership and contacts outside the organization.

Required:

• With an Associate's Degree, one (1) year of experience in healthcare and/or credentialing
• Without an Associate's Degree, three (3) years of experience in healthcare and/or credentialing

Desired:

• Bachelor Degree