RCM Credentialing Coordinator

Clarvida - Corporate

62d•$25•Remote

About The Position

As a Credentialing Coordinator, you will be responsible for verifying and maintaining records of practitioners’ credentials and ensuring compliance with applicable standards and regulations. This role ensures that healthcare providers are appropriately authorized and able to deliver services to clients in accordance with payer and regulatory requirements.

Requirements

High School Diploma or equivalent
1-3 years of experience in credentialing and contracting
Ability to respond effectively to sensitive inquiries or complaints
Strong interpersonal skills and ability to work with staff at all levels
Ability to manage multiple tasks in a fast-paced environment
Proficiency with Microsoft Office and billing applications
Strong attention to detail and problem-solving skills
Excellent written and verbal communication skills

Responsibilities

Receive requests for provider credentialing
Review provider documentation including certifications, education, experience, and licensure to meet payer requirements
Submit and manage provider applications for enrollment with commercial insurance, Medicare, and Medicaid Managed Care plans, as applicable
Track application progress and follow up with payers as necessary
Maintain accurate and organized records of credentialing and enrollment activities
Establish and maintain CAQH profiles for providers, ensuring timely re-attestation
Ensure timely revalidations to prevent termination
Facilitate enrollment of behavioral health providers with insurance companies, Medicaid, Medicare, and other third-party payers
Complete enrollment processes for new providers and assist with re-enrollment as needed
Maintain up-to-date knowledge of payer credentialing requirements and processes
Assist providers with enrollment-related tasks as needed
Organize and manage electronic records related to provider enrollment status and documentation
Maintain tracking and submit reports on credentialing and enrollment activities as requested by management
Liaise with internal departments and external stakeholders to resolve credentialing or enrollment issues
Provide support and training to providers regarding credentialing and enrollment procedures
Serve as a primary point of contact for providers and staff regarding payer enrollment
Prioritize workload to support agency revenue and management goals
Respond to inquiries promptly and escalate issues when appropriate

Benefits

Paid vacation days (increase with tenure)
Separate sick leave that rolls over annually
Up to 10 paid holidays
Medical, dental, and vision insurance options
DailyPay – access your earnings without waiting for payday
Training, development, and continuing education opportunities
401(k)
Free licensure supervision
Pet insurance
Employee Assistance Program (EAP)
Perks @ Clarvida – national discounts on shopping, travel, Verizon, and entertainment
Mileage reimbursement
Cellphone stipend