Credentialing Coordinator - Dallas, Texas
About The Position
We're not just a workplace - we're a Great Place to Work certified employer! Proudly certified as a Great Place to Work, we are dedicated to creating a supportive and inclusive environment. At Sonic Healthcare USA, we emphasize teamwork and innovation. Check out our job openings and advance your career with a company that values its team members! Quality is in our DNA -- is it in yours? You are a superhero when it comes to patient specimens. You’ve got problem-solving instincts, a passion for patient care, and the drive to keep things running smoothly. You’re also looking for great benefits, the support of an all-star team, and an opportunity to grow your career. Join our front line of #HealthcareHeroes! Our mission is to advance the health and wellbeing of our communities as a leader in clinical laboratory solutions. Location: Remote Full-time: Benefit Eligible Days: Monday - Friday Hours: 8:00 AM - 5:00 PM In this role, you will: The Provider Enrollment & Credentialing Representative' main responsibility will be to ensure MD/DO licenses are maintained active, and that CME requirements are met in a timely manner. Additional responsibilities may also be to be accountable for the initiation of new credential files, ensuring the completeness of a new application as the first step in the credential's verification process, and participating in verification of credentials through correspondence, phone contact, internet sites and any other third-party vendor.
Requirements
- Bachelor’s Degree or the equivalent years of experience.
- Prior years of related experience; or equivalent combination of education and experience.
- Ability to solve complex problems to support the planning, organizing, and coordinating of provider payer credentialing.
- Knowledge of medical terminology, insurance billing, credentialing and licensing processes as demonstrated by work experience.
Responsibilities
- Initial credentialing and re-credentialing of physicians.
- Obtains Medical Licenses as required, as well as ensures that all medical staff meet and maintain active licensure.
- CME maintenance
- Oversee the maintenance of all certifications required to successfully license and credential all physicians with the exception of the laboratory’s CLIA licenses.
- Coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
- Conducts thorough background investigation, research and primary source verification of all components of the application file.
- Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
- Prepares credentials file for completion and presentation to Entity Credentialing Committees, ensuring file completion within time periods specified.
- Responsible for CAQH files for providers to ensure completion and maintain revisions/updates.
- Processes requests for Provider Enrollment ensuring compliance with criteria outlined in descriptions for both commercial and Government payers.
Benefits
- Appreciation for your work
- A feeling of satisfaction that you’ve helped people
- Opportunity to grow in your profession
- Free lab services for you and your dependents
- Work-life balance, including Paid Time Off and Paid Holidays
- Competitive benefits including medical, dental, and vision insurance
- Help saving for retirement, with a 401(k) plus a company match
- A sense of belonging – we’re a community!
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
