Coordinator, Credentialing

Cardinal Health

7d•$18 - $30

About The Position

Navista is an oncology practice alliance supporting community oncology sites while maintaining their independence. The Coordinator, Managed Care, Credentialing helps ensure active credentialing and enrollment status with contracted payers for all groups and providers, and that all required licenses and certifications remain current and active. Managed Care oversees payer-provider interactions related to reimbursement, including contracting, enrollment, and credentialing. The position documents and tracks credentialing, enrollment, re-credentialing, re-enrollment, and hospital privileging activities; coordinates provider enrollment; monitors licenses and certifications; and completes documentation needed for hospital privileges. The coordinator works to meet processing and reporting deadlines, participates in training and projects, and regularly updates the Credentialing Supervisor and team members on progress and status.

Requirements

At least three years of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database, preferred.
Specific knowledge of the payer environment and payer issues.
Ability to work a flexible schedule, including overtime and weekends, as necessary.
Excellent customer service and communication skills.
Ability to work independently and as part of a team.
Working experience with Excel spreadsheets and Microsoft Word documents.
College degree or commensurate working experience in healthcare preferred.
Credentialing database experience, such as IntelliCred, E-Vips, Vistar, Cactus, or Symed, preferred.

Nice To Haves

At least three years of credentialing or payer enrollment experience in a managed care or provider setting, including credentialing database experience.
College degree or commensurate working experience in healthcare.
Experience with credentialing databases such as IntelliCred, E-Vips, Vistar, Cactus, or Symed.

Responsibilities

Document and track credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities in the credentialing platform.
Maintain and monitor licenses and certifications in the credentialing platform to ensure compliance across all regions.
Participate in training sessions and special projects, including learning new workflows, completing required training, and adopting updated processes within established timeframes.
Coordinate initial provider enrollment and re-credentialing activities for all groups and providers.
Ensure facility and provider licenses and certifications are accurate and in good standing.
Complete forms and supporting documents required to obtain hospital privileges for physicians, as necessary.
Consistently meet processing and reporting deadlines.
Meet regularly with the Credentialing Supervisor and other team members to provide updates on credentialing and enrollment progress and status.
Perform other functions as required by management.