The Insurance Credentialing Coordinator is responsible for assisting with maintaining and resolving issues related to insurance credentialing

and enrollment for all LIPs (Licensed Independent Practitioners), MD, OD, PA, FNP, DDS, DMD, RD, LCSW, etc. As well as assisting

with re-credentialing for all LIPs with the various insurance carriers that PHS is contracted with. The position also assists with maintaining

and resolving issues with insurance companies regarding malpractice insurance. Responsible for maintaining guidelines outlined by

The Joint Commission Standards and all insurance companies and their affiliates. Assist with updating and maintain in house

credentialing database(s) as well as local and national credentialing databases such as NC Tracks, PECOS, CAQH, etc.

Performs other duties as assigned.

Position requires good organizational skills, understanding of computer systems application in insurance claims processing, knowledge of cost-based reimbursement, knowledge of medical diagnosis and procedure codes, ability to develop and conduct staff training, understanding of managed care concepts and the ability to communicate effectively in oral and written forms. Ability to work independently and meet datelines in a timely manner.

Requires frequent sitting for long periods, operation of standard office machines and computers. May require lifting of up to 25 pounds.

Requires eye-hand coordination and manual dexterity. Requires the use of office equipment, such as computer terminals, telephones or

copiers. Requires normal vision range. Contact with all providers as needed and other outside vendors.