Credentialing Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $19 - $21 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Health Network One

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1999

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Health Network One is a healthcare network management company that partners with health plans to manage specialty outpatient services (including outpatient therapy, routine and medical eye care, dermatology, and podiatry) under full-risk arrangements. The company operates nationally, covering over 7 million lives and contracting with tens of thousands of providers, and offers delegated services such as utilization management, credentialing, claims and network management. Health Network One emphasizes value‑based solutions, clinical quality, cost reduction for professional and facility spend, and holds NCQA accreditation and HITRUST CSF certification.

📋 Description

• Receive and process all credentialing and re-credentialing applications according to company policies and procedures • Maintain accurate and complete records on application status • Enter provider information into the computer system • Prepare new provider and re-credentialing applications for Credentialing Committee review • Attend monthly Credentialing Committee meetings as needed and assist with preparation • Maintain established initial and re-credentialing timelines • Communicate with providers to update expired credentials, clarify information, and address credentialing issues • Maintain strict confidentiality regarding provider credentials • Adhere to company HIPAA policies and procedures • Ensure integrity of data entered into company systems and databases • Perform additional assigned duties and related essential duties

🎯 Requirements

• High school diploma or general education degree (GED) • Two years or more of managed care credentialing experience • Bilingual English/Spanish preferred • College experience preferred • Ability to maintain confidentiality of provider credentials • Knowledge of HIPAA policies and procedures • Ability to ensure data integrity in company systems and databases • Ability to meet qualitative and/or quantitative productivity standards • Ability to maintain reasonably regular, punctual attendance • Ability to work the regular schedule and shift • Compliance with personnel policies and procedures