Managed Care Credentialing Coordinator

Job not on LinkedIn

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $24 - $36 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Advocate Aurora Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

💰 $10.2M Grant on 2019-08

Healthcare • Healthcare Insurance

Advocate Aurora Health is a leading healthcare organization that operates across various regions including Central Chicagoland, Central Wisconsin, Greater Milwaukee, and more. With a diverse range of career areas such as advanced practice clinicians, behavioral health, nursing, and more, Advocate Aurora Health is committed to helping people live well. The organization offers numerous benefits and opportunities for career advancement, fostering an environment where individuals can thrive and innovate in the healthcare sector. Advocate Aurora Health prioritizes the safety of its candidates and maintains a robust recruitment process to protect sensitive information.

📋 Description

• Manage enrollment of employed and contracted AAMG providers by determining appropriate credentialing variables, demographics, and service lines • Participate in or request meetings with key AAMG contacts to determine credentialing routes and enrollment processing for unique hiring or contractual arrangements • Collaborate with multiple departments and areas to streamline credentialing and enrollment processes • Track files through all stages to meet deadlines and managed care credentialing committee schedules • Maintain proactive communication regarding credentialing, enrollment, and government payor activation processes • Oversee receipt, review, and processing of practitioner demographic, specialty, other changes, and resignation requests for APP Network Management processing and distribution to commercial payers • Communicate with the Credentials Verification Office, hospital medical staff offices, contract entities, physicians, and group practice offices via phone, fax, and written correspondence • Support Managed Care Credentialing Coordinators with verification processing and credentialing database maintenance for new applicants and reapplicants • Track timely submission of recredentialing applications from AAMG • Perform data entry and record keeping for ancillary practitioners employed by AAMG • Track licensure, insurance, and board certification expirables for AAMG practitioners credentialed through APP • Respond to internal and external questions and resolve delayed, incomplete, or problematic credentialing and provider enrollment matters according to established policies and procedures • Represent the team in AAMG Acquisitions, AAH Payer Activation, Advocate Intensivists, and Office of APC weekly meetings

🎯 Requirements

• High School Graduate • Four (4) years’ experience in administrative support position including database management • Managed Care credentialing experience (not provider enrollment) • Excellent communication, organizational and problem solving skills • Advanced proficiency in Microsoft Office (Excel, Access, PowerPoint and Word) and credentialing software • Knowledge of accrediting and regulatory agencies including Joint Commission, DNV, HFAP, CMS, OSHA, NCQA, and applicable state and federal law • Knowledge of hospital and system-wide policies regarding licensed independent practitioners in the hospital setting • Proven track record of effective interactions with physicians and other health care professionals • Ability to work effectively and independently • Demonstrated ability to effectively manage multiple priorities

🏖️ Benefits

• Benefits eligible • Premium pay such as shift, on call, and more based on a teammate's job • Incentive pay for select positions • Opportunity for annual increases based on performance • Paid Time Off programs • Medical, dental, vision, life, and Short- and Long-Term Disability benefits • Flexible Spending Accounts for eligible health care and dependent care expenses • Adoption assistance and paid parental leave • Defined contribution retirement plans with employer match • Other financial wellness programs • Educational Assistance Program