Credentialing and Enrollment Coordinator (FT, Days)
Thomas Jefferson University•Philadelphia, PA
•Onsite
About The Position
Responsible for the credentialing and enrollment of Jefferson Medical Group (JMG) physicians with contracted commercial and government payers. Works with assigned department staff to ensuring required documentation is obtained and complete for a smooth enrollment process.
Requirements
- Knowledge of criteria for health plans payer enrollment.
- Experience with CMS/PECOS provider enrollment.
- Ability to multi-task.
- Strong organizational skills with keen attention to detail.
- Ability to work in a fast paced and high-profile environment meeting tight deadlines.
- Ability to interact effectively with a variety of people (such as physicians and medical staff offices).
- Strong written and verbal communication skills.
- Excellent PC skills with experience using Microsoft Office Package.
- High School Diploma
- Experience with Microsoft Office Suite-Teams, Word, Excel, Outlook-intermediate user.
- Comfortable with heavy workload and multiple conflicting priorities.
- Organized and detail-oriented.
Nice To Haves
- Preferred experience working in a managed care or medical setting.
- RCM experience a plus.
Responsibilities
- Prepare initial and recredentialing plan applications for non-delegated providers.
- Follow up and Track applications submitted to payers using credentialing software.
- Connect with payers regarding status of applications, correcting issues and resubmitting timely as needed.
- Process changes and terminations of providers timely.
- Investigate provider claim holds and release claims once confirmation of payer setup is complete.
- Maintain the integrity of physician and practice information as well as outside databases (CAQH, Availity, etc.).
- Completion of other projects as assigned to support the department.
Benefits
- medical (including prescription)
- supplemental insurance
- dental
- vision
- life and AD&D insurance
- short- and long-term disability
- flexible spending accounts
- retirement plans
- tuition assistance
- voluntary benefits
- tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
