Job Description
Our Client, a Retail Pharmacy company, is looking for a Coordinator III - Credentialing Analyst / Coordinator for their Cumberland, RI location.
Responsibilities:
Requirements:
Why Should You Apply?
Responsibilities:
- Responsible for the timely and accurate processing of all providers including NP’s/PA’s/MD’s Re-credentialing applications according to the Client Provider Credentialing Program
- Monitor Expired licensure reporting , data base tasks and maintain system updates and weekly reporting to leadership
- Manage Epic access for any providers that have out of compliance licensure and/or board certification.
- Analyst will work directly with other coordinators to ensure quality of work delivered, performance/productivity benchmarks are met, and all compliance related issues are properly addressed, trained and coached on a consistent basis.
- Conduct sanctions and compliance monitoring and alert Data Analyst Manager and Credentialing Manager of any undisclosed negative findings
- Process malpractice insurance verification requests according to internal policies when applicable
- Maintain the provider and physician SharePoint sites and Communicate provider status’s with leadership and other internal teams to meet timelines
- Submit system access requests upon credentialing approvals/clinic eligibility
- Support the payer enrollment team as needed to resolve any payer claim issues
- Monitor Provider and Clinic change/Termination reports and update data base accordingly Process Name changes according to Client policies and procedures
- Daily maintenance of provider credentialing grids with notification to appropriate teams
- Review and distribute all incoming mail as needed
- Support Payer Audits in accordance with Client, Joint Commission and NCQA requirements
- Maintain provider files with the most current information/documentation
- Notify system analyst and leadership of any system and state agencies interruptions / updates / password changes
- Make recommendations for process improvement and system efficiencies
- Attend and engage in all team meetings
- Model a positive attitude in interactions with team members
Requirements:
- Demonstrated understanding of initial credentialing and re-credentialing practices for medical professionals including primary source verification methods, compliance monitoring and expirable management.
- Proficient in quantitative analysis
- Understanding of Joint Commission Accreditation, NCQA and URAC credentialing standards.
- Ability to function independently and utilize critical thinking skills to accomplish goals and objectives
- Effective communication skills; verbal and written
- Strong interpersonal skills including the ability to work well with internal and external stakeholders
- Strong organizational skills and the ability to multitask
- Competent user of Microsoft Office, Outlook, MD Staff, Word, and Excel
- A minimum of 3 years experience in the healthcare industry with experience in credentialing
- Preferred Qualifications:
- NAMSS Certified Professional Credentialing Specialist (CPCS) certification
- Verifyable High School Diploma or GED Required
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
Numbers & Facts
| Location | Cumberland, RI |
| Industry | Management Consulting Services |
| Salary | $16–$25 Per Hour |
| Company Size | 2,000 to 2,499 employees |
| Year Founded | 2000 |
| Website | https://www.iconma.com/ |
Benefits
401K, Employee Referral Program, Life Insurance
About Company
ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.
- Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
- Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
- Founded in 2000
- 2000+ Employees
The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.
Skills
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