Credentialing Coordinator

Location

Philadelphia, PA | United States

Job description

Duties:

• The Credentialing Coordinator is responsible for processing and completing the credentialing and re-credentialing functions of all providers by NCQA, state, and federal requirements.

Principal Accountabilities:

• Validate completeness of provider applications before processing.
• Conducts primary source verification for all credentialing and re-credentialing applications.
• Monitors the progress and completion of all site visits by the provider network team to ensure completion within the established timeframe.
• Accurately enters all critical data elements of provider applications into the Credentialing system.
• Respond to phone inquiries received in the Credentialing phone queue from internal and external clients.
• Completes projects as assigned.

Skills:

• Intermediate knowledge of PC applications, including Microsoft Office.
• Strong verbal and written communication skills.
• Strong organizational skills are required.
• Ability to perform in a metrics-driven environment.

Education:

• High School/GED with 4 years of experience. OR
• Associate’s Degree with 1 to 2 years of experience. OR
• Bachelor’s Degree with 0 to 1 years of experience.
• 0 to 4 years of prior provider credentialing experience based on a combination of education and experience.

Certification and Licences:

• RHIA
• RHIT
• RN

Required Skills:

• AUDIT
• AUDITS
• DATA ENTRY
• DATABASE
• DATABASES

Additional:

• LPN
• QM
• RHIA
• RHIT
• RN
• TELEPHONE
• TRAINING

Ohm Systems, Inc. specializes in IT and Healthcare staffing services, dedicated to linking highly skilled professionals with our public and private clients across the United States. Our track record showcases our commitment to delivering outstanding staffing and consultancy solutions to our clients. We prioritize diversity and inclusivity and take pride in being an employer that promotes equal opportunities and affirmative action. Our goal is to foster an inclusive work environment that embraces individuals from all backgrounds, irrespective of their gender, race, or orientation.

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