Coordinator, Credentialing

Cardinal Health, Inc.; United States; On-site; USD 25,000 - 41,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off

401k savings plan

Health savings account (HSA)

Flexible spending accounts (FSAs)

Job summary

Cardinal Health, Inc. seeks a Coordinator, Managed Care, Credentialing to support credentialing and enrollment across contracted payors for multiple groups and providers. This role ensures licensure is updated and active, and coordinates enrollment activities.

The position requires at least three years of credentialing or payer enrollment experience, knowledge of payer issues, and proficiency with Excel and credentialing databases. It offers a competitive hourly wage and benefits.

Qualifications

• Three years credentialing or payer enrollment experience.
• Knowledge of payer environment and issues.
• Flexibility to work overtime, including weekends.
• Excellent customer service and communication skills.
• Ability to work independently and as part of a team.
• Experience with Excel and Word.
• Healthcare-related college degree or commensurate experience preferred.
• Experience with credentialing databases such as IntelliCred, E-Vips, Vistar, Cactus, or Symed.

Responsibilities

• Document and track credentialing/enrollment, re-credentialing, and hospital privileging activities.
• Maintain licenses and certifications in the credentialing platform to ensure compliance.
• Participate in training sessions and projects; adopt updated processes on time.
• Coordinate provider enrollment for all groups and providers.
• Ensure licenses and certifications are accurate and in good standing.
• Complete forms to obtain hospital privileges as needed.
• Meet processing/reporting deadlines consistently.
• Meet with Credentialing Supervisor and team to provide status updates.
• Perform other functions as required by management.

Skills

Credentialing experience

Payer enrollment

Customer service

Communication

Teamwork

Excel

Word

Payer environment knowledge

Flexible schedule

Credentialing databases

Education

College degree or healthcare experience

Tools

IntelliCred

E-Vips

Vistar

Cactus

Symed

Job description

Coordinator, Managed Care, Credentialing

About Navista

We believe in the power of community oncology to support patients through their cancer journeys. As an oncology practice alliance comprised of more than 40 sites, Navista provides the support community practices need to fuel their growth – while maintaining their independence.

What Revenue Cycle Management (RCM) contributes to Cardinal Health
Practice Operations Management oversees the business and administrative operations of a medical practice.

What Managed Care contributes to Cardinal Health
Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other activity as it relates to payer interaction.

The Coordinator, Managed Care, Credentialing is responsible for ensuring an active credentialing/enrollment status with all contracted payors for all groups and providers. This position is also responsible for ensuring that all licensure is updated and active for all groups and providers.

Responsibilities

• Responsible for documenting and tracking all credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities within the credentialing platform
• Maintain and monitor all licenses and certifications in the credentialing platform to ensure compliance within all regions.
• Participate in training sessions and special projects such as learning new system workflows, completing required training, and adopting updated processes within established timeframes.
• Coordinate provider enrollment activities (including initial enrollments or re-credentialing) for all groups and providers.
• Ensure all facility and provider licenses and certifications are accurate and in good standing at all times.
• Complete all forms and supporting documents required to obtain hospital privileges for physicians, as necessary.
• Ensure that all processing and reporting deadlines are consistently achieved.
• Meet regularly with Credentialing Supervisor and other team members to provide updates on progress and status of credentialing and enrollment matters.
• Performs any other functions as required by management.

Qualifications

• At least three (3) years of experience of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database preferred
• Specific knowledge of the payer environment and payer issues
• Ability to work a flexible schedule (including overtime, and weekends), as necessary.
• Excellent customer service and communication skills.
• Ability to work independently and as part of a team.
• Working experience with Excel spreadsheets and Microsoft Word documents.
• College degree or commensurate working experience in healthcare preferred
• Credentialing database experience (such as IntelliCred, E-Vips, Vistar, Cactus, Symed, etc.) preferred

What is expected of you and others at this level

• Applies acquired job skills and company policies and procedures to complete standard tasks
• Refers to policies and past practices for guidance
• Receives general directions on standard work; receives detailed instruction on new assignments
• Consult with supervisor or senior peers on complex and unusual problems

Anticipated Pay Range:$18.20 - $29.70

Bonus eligible:No

Benefits:Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.