Lakeshore Talent

Lakeshore Talent is looking for qualified candidates to fill a Credentialing Coordinator role with a healthcare company located in Loveland, CO.

This is starting as a 3-month contract and it pays $18-$24/hour.

JOB DESCRIPTION: The Credentialing Coordinator is responsible for ensuring that each medical office is up to date on their payer contracts, and that that they have access to their fee schedules and an understanding of those fee schedules. This position obtains the credentialing packets from the offices and manages the credentialing files as well as answers any customer service questions and complaints.

JOB DUTIES:

  • Gather documents required to initiate credentialing and configuration of a member’s health plan contracts.
  • Serve as a liaison between member practices and payers for problem resolution, contract disputes, reimbursement issues, credentialing etc.
  • “Update” health plans with additions, demographic changes and terminations applicable to contracts.
  • Follow up with health plans monthly to request effective dates and supply additional documentation 
  • Manage CAQH (Council for Affordable Quality Health Care) profiles for approximately 300 providers; re-attest every 90 days, upload renewed documents and communicate with practices regarding demographic updates and other applicable payer credentialing sites.
  • Facilitate physician fee schedule configuration through the messenger model process on behalf of individual member practices
  • Answer customer service call about credentialing, payer issues etc.
  • Initiate Credentialing Fee invoicing and collection of membership dues through QuickBooks
  • Payor Relations and Physician Advocacy with claims, demographic or credentialing disputes
  • Coordinates Roster changes and maintains email distribution lists to all member physicians, office staff and personnel within Sales Force Marketing or other marketing and communications tools.
  • Builds strong interpersonal working relationships with practice staff, physicians and payer representatives; utilize problem solving skills to resolve issues

QUALIFICATIONS:

  • Minimum three (3) years’ experience with credentialing, contracting, or network development in a health insurance environment required
  • CPCS certified preferred
  • College degree in business, communications or health care administration preferred
  • Must have experience in customer service, medical practice management and physician credentialing
  • Excellent written, verbal, interpersonal communications skills
  • Proficient in Microsoft Office programs (i.e., Word, Outlook, Power Point & Excel (VLOOKUP)).
  • Must be highly organized

Job ID: 42461

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