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Posted By Administrator
- September-21-2007
- 12:05pm
- 0 comments
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Job Description
Payer Credentialing Coordinator
Coordinated Primary Care
Position Summary: Responsible for management of all third party insurance credentialing for CPC Physicians and Nurse Practitioners. Responsible for initial credentialing and re-credentialing processes. Responsible for assisting in the development and implementation of administrative policies and procedures related to credentialing and billing process which are directly related to credentialing.
Essential Functions:
Must have minimum of 2-3 years of credentialing experience and be able to demonstrate independent decision making
Must have knowledge of professional billing as it relates to credentialing processes
Must complete all applications in a timely and accurate manner
Must have success in establishing great working relationships with payer contacts, providers, and office staff
Must possess excellent communication skills
Must have working knowledge of physician practice
Responsible for coordinating processes between the medical staff office and the physician
Responsible for working closely with the physician/hospital organization
Must have excellent follow up with physicians and payer contacts
Must be organized and steadfast with a tickler system reminding providers of deadlines
Must attend community, payer, and physician organization meetings on a regular basis
Must have expertise in building relationships with payer contacts
Education/Experience
Two to three years physician office experience. Knowledge of third party insurance credentialing requirements, medical terminology, typing and computer skills, ability to work independently, communication skills both verbal and written. Ability to build strong relationships with provider relations staff and physician practices.
Candidates interested in this position should contact:
Doug MacNeil
Director, Employment and HR Operations
HealthAlliance Hospitals
A Member of UMass Memorial Health Care
60 Hospital Road
Leominster, MA 01453
(978) 466-4061
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