Credentialing Coordinator

Community Health Network • Indianapolis, IN

5d

About The Position

Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered — and we couldn’t do it without you. Make a Difference The Credentialing Coordinator is responsible for management and implementation of the ProHealth Provider Network Credentialing Process. This role will be coordinating all activities related to network credentialing including, but not limited to applications, verifications, Credentialing Committee and maintenance of system files and documents. Must maintain current knowledge of payer contracts to load contracted payers to the credentialed provider. Provides completion of third-party payer credentialing and contracting applications to allocated client base. Additional functions include the completion of provider state and federal license renewals, hospital initial and reappointment applications, and collection of provider information, signatures, and documents. Remain compliant with all National Committee for Quality Assurance (NCQA) changes and ensure all changes are made to the Credentialing Process. Exceptional Skills and Qualifications Applicants for this position should be able to collaborate with others in a team setting, have excellent communication skills, and a positive attitude toward problem-solving.

Requirements

• High School Diploma or GED equivalent required.
• Three to five (3-5) years of experience in credentialing or a strong background in the health insurance industry or managed care field.
• Strong attention to detail.
• Familiarity with the National Committee for Quality Assurance (NCQA).
• Applicants for this position should be able to collaborate with others in a team setting, have excellent communication skills, and a positive attitude toward problem-solving.

Responsibilities

• Management and implementation of the ProHealth Provider Network Credentialing Process.
• Coordinating all activities related to network credentialing including, but not limited to applications, verifications, Credentialing Committee and maintenance of system files and documents.
• Maintain current knowledge of payer contracts to load contracted payers to the credentialed provider.
• Completion of third-party payer credentialing and contracting applications to allocated client base.
• Completion of provider state and federal license renewals, hospital initial and reappointment applications, and collection of provider information, signatures, and documents.
• Remain compliant with all National Committee for Quality Assurance (NCQA) changes and ensure all changes are made to the Credentialing Process.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees