CareCentrix

  • Coordinator - Credentialing

    Job Locations US-CT-Hartford
    Job ID
    2018-5952
  • Overview

    The Credentialing Coordinator will assist in the organization of all facets of the provider credentialing process with support from a Credentialing Specialist. The Credentialing Coordinator is responsible for provider compliance as it pertains to credentialing standards. 
     

    Responsibilities

    • Process provider work tickets as assigned. Update system with any important information to ensure that facilities are in compliance with current standards.
    • Contact provider to obtain all necessary credentialing elements to ensure completion.
    • Coordinate the receipt of provider applications, data stamp applications received & bundle completed provider files.
    • Run OIG and SAM sanction verification and NPDB when applicable.
    • Input specified provider data into database and track expiration dates for current file and system maintenance.
    • Assist in preparing the credentialing file for all providers.
    • Maintain provider files in the Vistar database system as needed.
    • Mail provider contracts and notice of determination following approval from credentialing committee.
    • Meet all customer SLA’s on notification to providers with committee decision, and provide notification if the file is missing credentialing elements.

    Qualifications

    • HS diploma or equivalent
    • Minimum of 1 year accreditation or credentialing experience, preferably in the managed care industry, preferred but not required.
    • Knowledge of NCQA and URAC standards preferred

     

    CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.

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