Credentialing Coordinator

Panoramic Health

Come Join our team!!

Credentialing Coordinator administers the physician and mid-level payor enrollment and hospital privilege credentialing applications process. The Credentialing Coordinator is responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of enrolling individual providers and clients with payors and hospitals. In this role, you will ensure the setup of the clients for participation status in the EMR, prepare and submit applications, follow up on the status of applications and track the progress on all pending applications.

Responsibilities include:

• Implements the physician enrollment and hospital credentialing process for clients who request credentialing services.
• Maintain the timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed and maintain a strict level of confidentiality for all matters pertaining to provider credentials.
• Communicate with billing and the office managers on updates as needed and explain payer information requirements.
• Coordinates credentialing data needed for onboarding, contracting, and other related purposes. Credentialing data includes but is not limited to the medical degree, Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, malpractice insurance and state insurance form.
• Works closely with providers and practice managers to obtain missing documentation pertaining to the onboarding and reappointment process. Obtains required provider signatures and follows up with the entities on documentation submitted.
• Maintains provider information and demographics for all providers.
• Responds to internal and external inquiries on routine credentialing and contracting matters.
• Monitors and advises clients on expirations including but not limited to: Medical License, DEA, CDS, COI, TB, Flu.
• Create & maintain PECOS & NPPES.
• Run OIG report on onboarding providers.
• Maintain quarterly health plan rosters.
• Create & maintain provider CAQH.
• Provider hospital dues.
• Perform other duties and responsibilities as required, assigned, or requested.

Qualifications:

• High School Diploma or GED required. Bachelor’s degree preferred.
• Minimum of 2 years credentialing experience.
• Proficiency in Microsoft Office, particularly Excel, Word, and Outlook.
• Knowledge of the Medicare, Medicaid & third-party provider enrollment processes.
• Hospital privileging experience including but not limited too primary sourcing.
• Proficiency in CAQH, PECOS & NPPES.

The Company is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. The company is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement, transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment

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