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Credentialing Coordinator

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POST DATE 9/12/2016
END DATE 10/24/2016

Ajilon Professional Staffing Jacksonville, FL

Jacksonville, FL
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Full Time
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span B Credentialing Coordinator Job in Jacksonville, FL /B br   br A Credentialing Coordinator position is available courtesy of Ajilon Professional Staffing. This position is with an organization dedicated to the best and is centrally located in the Jacksonville area. If you have recent credentialing experience and enjoy working in a fast paced environment, please apply! br   br The Credentialing Coordinator oversees the process to obtain hospital privileges and insurance payer numbers. The Credentialing Coordinator is in charge of making sure all group and provider information is accurate and maintained with all insurance payers and credentialing databases to ensure collections. br   br B Responsibilities /B br   br ul
li Coordinate provider on-boarding /li ul
li Hospital credentialing /li li Insurance payer credentialing /li /ul
li Create and maintain ARNP protocols with the Board of Nursing /li li Alert Board of Nursing of employed and terminated ARNPs. /li li Ensure that credentials are accurately distributed to the necessary parties ( i.e. nursing facilities, hospitals, insurance payers, etc.) /li li Ensure that certifications/licenses are kept current/active in provider’s files. /li li Add/maintain practice and provider demographics on various databases that insurance carriers access for enrollment and payment. /li ul
li Maintain practice information in providers CAQH database. /li li If agreed by provider, maintains provider information in CAQH database. /li /ul
li Maintain practices NPI information. /li li If agreed by provider, maintain provider NPI information. /li li Apply for HSP providers Malpractice Insurance /li li Oversee new state location set-ups /li ul
li Obtain legal name, ownership, and TIN from legal department /li li Apply for NPI number /li li Responsible for obtaining government and commercial group insurance numbers (MDE sends out applications and follows) /li /ul
li Responsible for credentialing and re-credentialing. /li ul
li Providers at hospital Privileges /li li Providers with Insurance carriers /li li Group Insurance Carrier numbers /li /ul
li Ensure all providers are active on CheckMedic and passed the credentialing process /li li Notify all insurance carriers when changes are made that affect the billing/claims process /li li Advise leadership of any potential credentialing or other issues that may require further investigation /li li Manages 3rd party Credentialing Vendor /li li Communicates and works directly with providers, Hospital Staff and other 3rd parties fostering positive relationships and partnerships /li /ul
  br B Requirements /B br ul
li High school diploma or equivalent /li li Previous credentialing experience required /li li Strong problem solving strategies and the ability to work well with deadlines /li li Team player and positive attitude /li li Proficient with Microsoft Outlook, Word, PowerPoint, and Excel, as well as web-based database programs and the Internet /li li Ability to read and comprehend simple instructions, short correspondence, and memos /li li Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization /li li Possess the skills needed to add