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Posted 2 days ago
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Requirements and responsibilities
Job Title: Credentialing Coordinator
Duration: 3 plus month with possible extension
Location: Fully Remote
Pay Range: $18- $19.00/hr
Credentialing Coordinator role will be responsible on ensuring compliance with NCQA, URAC, Medicare, Medicaid, Delegation agreements and other pertinent client requirements, policies and procedures, client health plan contracts, URAC guidelines and applicable state and federal requirements.
Responsibilities may include:
Verifying State Licenses, exclusions lists, DEA’s, Board Certifications and Medicaid/Medicare Enrollment Verifications on an ongoing basis to ensure qualified and approved clinicians remain active in the network.
Enrolling clinicians in Medicare and Medicaid following state and federal guidelines
Applying for state licensure for clinicians
S/He will maintain strong cross-departmental relationships with Recruiting, Production, and Education This role will report to our Supervisor of the Credentialing Hub.
Candidates will monitor files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate.
Enters, updates, and maintains data from provider applications into the credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses and in accordance with internal policies and procedures.
Flexible shifts between 7:00 AM – 5:00 PM CST
• - Options for 30-minute or 1-hour lunch breaks
• - Must work CST hours regardless of time zone
Experience & Skills:
• - Preferred Experience: 1–3 years
• - Credentialing or licensure experience highly preferred
Optionally, you can add more information later (benefits, pre-screening questions, etc.)