Assistant Coordinator of Payer Credentialing

St. Francis Medical Center • Cape Girardeau, MO

106d

About The Position

This position is responsible for all aspects of credentialing and re-credentialing of hospital, all physician practices, and providers for Saint Francis Healthcare System. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans accurately and timely. Maintains data in credentialing database and online systems. Ensure timely renewal of licenses, certification, and validations. This position reports directly to the Medical Staff Coordinator but will have a matrixed reporting relationship to revenue cycle leadership.

Requirements

• High school graduate/equivalent - required
• Two to five years of payer credentialing experience with strong understanding and knowledge of Medicare, Medicaid, commercial payers, hospital & rural health specific requirements - required
• Excellent oral and written communication skills to communicate with diverse customer groups, including but not limited to, physicians, practice management and staff, vendors, and payers.
• Strong problem solving skills and attention to detail.
• Exceptional organization skills with intensely accurate follow through.
• Ability to work independently with minimal supervision.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.

Nice To Haves

• Certified Provider Credentialing Specialist - preferred

Responsibilities

• Compiles and maintains current and accurate data for hospital and providers.
• Compiles hospital and provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
• Maintains copies of current state licenses, DEA certificates, and other required credentialing documents.
• Maintains knowledge of current health plans and agency requirements for credentialing inclusive of Rural Health, Medicare, Medicaid and broad range of commercial payers.
• Sets up and maintains information in online credentialing databases and systems.
• Tracks license and certification expirations for hospital and all providers to ensure timely renewal, revalidation and re-credentialing.
• Ensures information remains current with all health plans, agencies and other entities.
• Works with insurance representatives to maintain accurate provider information in health plan directories.
• Performs other duties as assigned.

Benefits

• Equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, or genetics.
• Support for overall health and wellness of colleagues by discouraging the use of tobacco and nicotine products.
• Free tobacco/nicotine cessation program as part of Employee Assistance Program.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED
• Number of Employees: 101-250 employees