Credentialing and Administrative Coordinator

Panoramic Health•Tempe, AZ

About The Position

The Credentialing and Administrative Coordinator administers the physician and mid-level payor enrollment and hospital privilege credentialing applications process. This role is responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of enrolling individual providers and clients with payors and hospitals. Key duties include ensuring client setup for participation status in the EMR, preparing and submitting applications, following up on application status, and tracking the progress of all pending applications. Additionally, this position will manage schedules and assist with operational projects for the practice's lead physician.

Requirements

High School Diploma or GED required.
Minimum of 2 years credentialing experience.
Proficiency in Microsoft Office, particularly Excel, Word, and Outlook.
Knowledge of the Medicare, Medicaid & third-party provider enrollment processes.
Hospital privileging experience including but not limited to primary sourcing.
Proficiency in CAQH, PECOS & NPPES.

Nice To Haves

Bachelor’s degree preferred.

Responsibilities

Implements the physician enrollment and hospital credentialing process for clients who request credentialing services.
Maintains timelines on enrollment/credentialing schedules.
Communicates with providers and other departments to update as needed.
Maintains a strict level of confidentiality for all matters pertaining to provider credentials.
Communicates with billing and office managers on updates as needed and explains payer information requirements.
Coordinates credentialing data needed for onboarding, contracting, and other related purposes.
Works closely with providers and practice managers to obtain missing documentation pertaining to the onboarding and reappointment process.
Obtains required provider signatures and follows up with entities on documentation submitted.
Maintains provider information and demographics for all providers.
Responds to internal and external inquiries on routine credentialing and contracting matters.
Monitors and advises clients on expirations including but not limited to: Medical License, DEA, CDS, COI, TB, Flu.
Create & maintain PECOS & NPPES.
Run OIG report on onboarding providers.
Maintain quarterly health plan rosters.
Create & maintain provider CAQH.
Provider hospital dues.
Perform other duties and responsibilities as required, assigned, or requested.