IL
Coordinator III - Credentialing Analyst / Coordinator
ICONMA, LLC
- 🇺🇸 United States
- On-site
- 21 hours ago
- $16 – $25 / hour
- Epic
- Outlook
- Excel
21 hours ago
Responsibilities:
- Responsible for the timely and accurate processing of all providers including NP’s/PA’s/MD’s Re-credentialing applications according to the Client Provider Credentialing Program
- Monitor Expired licensure reporting , data base tasks and maintain system updates and weekly reporting to leadership
- Manage Epic access for any providers that have out of compliance licensure and/or board certification.
- Analyst will work directly with other coordinators to ensure quality of work delivered, performance/productivity benchmarks are met, and all compliance related issues are properly addressed, trained and coached on a consistent basis.
- Conduct sanctions and compliance monitoring and alert Data Analyst Manager and Credentialing Manager of any undisclosed negative findings
- Process malpractice insurance verification requests according to internal policies when applicable
- Maintain the provider and physician SharePoint sites and Communicate provider status’s with leadership and other internal teams to meet timelines
- Submit system access requests upon credentialing approvals/clinic eligibility
- Support the payer enrollment team as needed to resolve any payer claim issues
- Monitor Provider and Clinic change/Termination reports and update data base accordingly Process Name changes according to Client policies and procedures
- Daily maintenance of provider credentialing grids with notification to appropriate teams
- Review and distribute all incoming mail as needed
- Support Payer Audits in accordance with Client, Joint Commission and NCQA requirements
- Maintain provider files with the most current information/documentation
- Notify system analyst and leadership of any system and state agencies interruptions / updates / password changes
- Make recommendations for process improvement and system efficiencies
- Attend and engage in all team meetings
- Model a positive attitude in interactions with team members
Requirements:
- Demonstrated understanding of initial credentialing and re-credentialing practices for medical professionals including primary source verification methods, compliance monitoring and expirable management.
- Proficient in quantitative analysis
- Understanding of Joint Commission Accreditation, NCQA and URAC credentialing standards.
- Ability to function independently and utilize critical thinking skills to accomplish goals and objectives
- Effective communication skills; verbal and written
- Strong interpersonal skills including the ability to work well with internal and external stakeholders
- Strong organizational skills and the ability to multitask
- Competent user of Microsoft Office, Outlook, MD Staff, Word, and Excel
- A minimum of 3 years experience in the healthcare industry with experience in credentialing
- Preferred Qualifications:
- NAMSS Certified Professional Credentialing Specialist (CPCS) certification
- Verifyable High School Diploma or GED Required
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
Coordinator III - Credentialing Analyst / Coordinator · ICONMA, LLC