Credentialing Coordinator

InnovaCare • Miami, FL

1d

About The Position

This position is responsible to serve as primary liaison of contracted Providers and MMM Healthcare, Inc. departments for purposes of provider credentialing and monitoring processes assuring compliance with applicable CMS standards regulations. Collect, analyze, report, and act on performance and health outcome data to perform the Quality Improvement Program.

Requirements

• Associate's degree (A. A.) in Health or Business Administration or equivalent from two-year college or technical school.
• One year experience in Credentialing or equivalent combination of education and experience.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Ability to write reports, business correspondence, and procedure manuals.
• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
• Word processing skills must be proficient and accurate with knowledge of grammar, spelling and punctuation in Spanish and English.
• Ability to calculate figures amounts such as discount, interest, commissions, proportion and percentages.
• Ability to apply concepts of basic algebra.
• Ability to compute rate, ratio, and percent and to draw and interpret graphs.
• Ability to apply common sense understanding to carry out instructions ]furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables in standardized situations.
• Customer Service Skills: practicing, valuing and supporting service to both internal and external customers.
• Time Management Skills: establishing priorities and accomplishing tasks in a timely manner
• Team Work: ability to work in a team environment to create solutions to problems
• Computer Experience: Windows environment, Microsoft Word, Excel, Power Point and internet.
• Multi task: ability to handle multiple tasks and work under pressure.
• Availability to work over time hours.
• This position requires working while sitting, standing, talking, hearing and walking.
• This position requires weight to be lifted or force to be exerted up to 15- 20 pounds.

Nice To Haves

• Data base familiarity and EZ Cap a plus.

Responsibilities

• Provides initial evaluation of provider documentation to complete the credentialing process assuring compliance with MMM Healthcare, Inc. policies and procedures.
• Develops implements and maintains contracted Providers files.
• Coordinates / advocates resolution of Providers credentialing issues and concerns.
• Participates in Credentialing Committee.
• Inter-departmental resource for all provider /credentialing issues, problems or concerns.
• Keep and maintain confidentiality of providers credentialing documentation.
• Participates in department special projects as requested.
• Prepares special reports for Credentialing Manager or Credentialing Supervisor as requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees