Credentialing Coordinator

Credentialing Coordinator

Title: Credentialing Coordinator

Duration: 3+ Months

Location: Doral, FL

The primary purpose of the job is:

The Credentialing Coordinator is responsible for processing and completing the credentialing and re-credentialing functions of all providers in accordance with NCQA, state, and federal requirements.

Principal Accountabilities:

· Validates completeness of provider applications prior to processing.

· Conducts primary source verification for all credentialing and re-credentialing applications.

· Monitors the progress and completion of all site visits by the provider network team to ensure completion within established timeframe.

· Accurately enters all critical data elements of provider applications into Credentialing system.

· Responds to phone inquiries received into the Credentialing phone queue from internal and external clients.

· Completes projects as assigned.

· 0-4 years of prior provider credentialing experience based on a combination of education and experience.

· High School/GED with 4 years of experience. OR Associate's Degree with 1-2 years of experience. OR Bachelor's Degree with 0-1 years of experience.

· Intermediate knowledge of PC applications, including Microsoft Office.

· Strong verbal and written communication skills.

· Strong organizational skills required.

· Ability to perform in a metrics-driven environment