Credentialing Coordinator

Job Locations US-MI-Farmington Hills
Company
Smile America Partners
Job Type
Full-Time
Category
Corporate

Overview

Credentialing Coordinator

JOB OVERVIEW:
Responsible for all aspects of the credentialing and re-credentialing processes for all providers who provide patient care for the Smile Programs. Responsible for ensuring providers are credentialed with health plans. Maintain up-to date for each provider in credentialing databases and online systems; ensuring timely renewal of licenses and certifications.

ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:

  • Complies and maintains current and accurate date for all providers
  • Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed
  • Maintains copies of current state licenses, DEA certificates, malpractice coverage, and any other required credentialing documents for all providers
  • Maintains knowledge of current health plan and agency requirements for credentialing providers
  • Sets up and maintains provider information in online credentialing databases and system
  • Tracks license and certification expiration for all providers to ensure timely renewals
  • Processes applications for credentialing and re-credentialing
  • Tracks licenses, DEA, and professional liability expiration for appointed providers
  • Maintains information in credentialing database

ADDITIONAL RESPONSIBILITIES:

  • Maintains confidentiality of provider information
  • Provides credentialing and privileging verification
  • Performs other duties as assigned

SKILLS:

  • Knowledge and understanding of the credentialing process
  • Ability to organize and prioritize work and manage multiple priorities
  • Excellent verbal and written communication skills including letters, memos, and emails
  • Excellent attention to detail
  • Ability to research and analyze data
  • Ability to work independently with minimal supervision
  • Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization
  • Proficient use of Microsoft Office applications (Word, Excel, Access) and Internet resources

Job Type: Full-time

Required license or certification:

  • Driver's License

Required education:

  • High school or equivalent

Credentialing CoordinatorJOB OVERVIEW: Responsible for all aspects of the credentialing and re-credentialing processes for all providers who provide patient care for the Smile Programs. Responsible for ensuring providers are credentialed with health plans. Maintain up-to date for each provider in credentialing databases and online systems; ensuring timely renewal of licenses and certifications. ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO: Complies and maintains current and accurate date for all providers Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed Maintains copies of current state licenses, DEA certificates, malpractice coverage, and any other required credentialing documents for all providers Maintains knowledge of current health plan and agency requirements for credentialing providers Sets up and maintains provider information in online credentialing databases and system Tracks license and certification expiration for all providers to ensure timely renewals Processes applications for credentialing and re-credentialing Tracks licenses, DEA, and professional liability expiration for appointed providers Maintains information in credentialing database ADDITIONAL RESPONSIBILITIES: Maintains confidentiality of provider information Provides credentialing and privileging verification Performs other duties as assigned SKILLS: Knowledge and understanding of the credentialing process Ability to organize and prioritize work and manage multiple priorities Excellent verbal and written communication skills including letters, memos, and emails Excellent attention to detail Ability to research and analyze data Ability to work independently with minimal supervision Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization Proficient use of Microsoft Office applications (Word, Excel, Access) and Internet resources Job Type: Full-time Required license or certification: Driver's License Required education: High school or equivalent

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