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    Credentialing Coordinator - Red Bank, United States - The Plastic Surgery Center

    The Plastic Surgery Center
    The Plastic Surgery Center Red Bank, United States

    1 month ago

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    Description
    The Plastic Surgery Center is seeking an organized and detail oriented Credentialing Assistant for a rapidly growing practice.

    You will be responsible for the effective, accurate and timely manage care credentialing for all clinicians (i.e., licensed independent practitioners and allied health practitioners) in accordance with federal, state and department procedures.

    Responsible generating accurate reports including the credentialing status and data related to clinician productivity. Maintains up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.

    *This is not a remote position and required candidates to work out of our office located in Red Bank, NJ

    Responsibilities and Duties

    • Completing and processing provider credentialing applications
    • Maintains current and accurate credentialing/privileging files for all licensed independent practitioners
    • Maintaining knowledge of current health plan and agency requirements for credentialing providers
    • Providing credentialing and privileging verifications if applicable
    • Notifies manage care plans of all terminations and demographic changes for all licensed individual practitioners (LIPs)
    • Audit managed care plans on a monthly basis to ensure that all LIPs are accurately enrolled with all appropriate practice locations
    • Complies and maintains accurate monthly reports/rosters of all enrolled/credentialed practitioners; confirming all providers are appropriately enrolled with the correct managed care plans
    • Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day to day credentialing and privileging issues as they arise
    • Assists with managed care delegated credentialing audits; conducts internal file audits
    • Utilizes the credentialing database, optimizing efficiency and performs query, report and document generation
    • Assists in the implementation and maintenance of processes and procedures including regulatory certification guidelines related to physician credentialing
    Qualifications

    • 1-2 years of current and relevant credentialing experience, knowledge of medical credentialing and privileging procedures and standards
    • Ability to efficiently and effectively manage multiple tasks to prioritize needs and meet deadlines
    • Strong attention to detail
    • Sound written and verbal communication skills
    • Ability to maintain confidentiality of information and exercise good judgment and discretion in handling and disseminating information
    • Ability to research and analyze data and to work independently with minimal supervision
    IND2


    Job Type:
    Full-time


    Benefits:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Health savings account
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • Monday to Friday
    Application Question(s):


    • What are your salary requirements? (provide numeric answer only)

    Experience:

    • Medical office: 1 year (Preferred)
    • Credentialing: 2 years (Required)

    Work Location:
    In person

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