Credentialing Coordinator, Medical Staff Office, Full Time, First Shift

UC Health•Cincinnati, OH

5d•Onsite

About The Position

This is a multi-faceted position encompassing elements of administrative tasks, customer service, and credentialing verifications. Prepares, documents, and completes credentialing data processes including applications and verifications for Medical and Allied Health staff. Performs administrative tasks, such as compiling data from providers, preparing applications, maintaining clean and organized files, and maintaining current documents and enrollments for providers.

Requirements

High School diploma or GED.
1 to 4 years of experience in a business office setting required.

Nice To Haves

CPCS (Certified Provider Credentialing Specialist) certification.
Healthcare and credentialing experience in a hospital, physician practice, or managed care environment preferred.

Responsibilities

Prepares, documents, and completes credentialing data processes.
Performs regularly recurring administrative tasks for maintaining Payor Enrollment data files.
Training and Self Development.
Customer Service.
Maintains Payor Enrollment data files to support effective entry, filing, storage, and retrieval of data and documents.
Assists department with performance improvement activities, clean up projects, and other duties as assigned.
Communicates with providers to gather information needed to enroll them with payors.
Update CAQH and Cactus database with new provider information.
Collates information and prepares credentialing files for review
Populate paper applications, Excel documents and online websites/portals to enroll providers.
Follows up on applications submitted.
Respond to requests for additional information needed for enrollments.
Submit revalidation/recertification applications every three to five years to maintain provider enrollments.
Respond to notices from payors needing information to maintain enrollments and payor directories.
Reattest CAQH every 120 days for all providers.
Submit license, DEAs and malpractice to payors to maintain enrollments.
Update CAQH and Cactus with demographic and name changes and submit updates to all payors.
Receives, opens, sorts and distributes mail/emails.
Participate in staff training that aligns with recognized improvement opportunities.
Work with supervisors and coworkers to learn all parts of the Enrollment Team.
Makes customer service a high priority.
Listens to, identifies, and responds quickly and appropriately to customer needs, both internal and external customers
Respond in timely manner
Execute required actions
Identify potential problems
Handles confidential materials
Maintain storage of files for orderly retrieval.