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    Credentialing Coordinator - Chicago, United States - Axelon

    Axelon
    Axelon Chicago, United States

    3 weeks ago

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    Description


    Under the direction of the Manager, the Credentialing Coordinator will have responsibility for coordinating, monitoring, and maintaining the credentialing and re- credentialing of Provider Applicants.

    This includes facilitating all aspects of appointment, reappointment, and privileging maintenance for managed care, medical staff, and non-physician providers.

    The Credentialing Coordinator assists in compliance with the contracted managed care payers, accrediting and regulatory agencies (i.e., NCQA, Joint Commission, URAC), in regards to credentialing while developing and maintaining a working knowledge of the organizational guidelines, statutes and laws.


    • Collect relevant and critical data to determine applicant's eligibility to be credentialed.
    2. Evaluate and review applications for accuracy and completeness.
    3. Gather and conduct primary source verifications of confidential healthcare provider credentials.
    4.

    Contact and follow up with applicant, primary source organizations department and contracted Medical Staff Offices to obtain documentation relevant to the credentialing process and data entry of all credentialing information provided.

    5. Maintain the confidentiality of all business, work, and credentialing information.
    6. Assist in managing the flow of information between the managed care payers, contracted MSO facilities and Health.
    7. Process and communicate all Health practitioner additions, deletions, and/or changes to all contracted managed care payers.
    8. Experience with Echo credentialing software
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