Credentialing Coordinator

Transformations Care Network; United States; A distancia; USD 32.000 - 33.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical coverage

Dental coverage

Vision coverage

401K

Low-cost virtual care

Remote-friendly environment

Descripción de la vacante

Transformations Care Network is seeking a Credentialing Coordinator to support credentialing for physicians and other billable providers across multiple locations. You will ensure timely applications, enrollments, and re-credentialing activities while maintaining accurate provider data.

The role reports to the Credentialing Supervisor and involves collaboration with multiple departments, including payer relations and operations, to prevent any lapses in coverage or status.

Formación

• Minimum 2 years physician credentialing experience.
• High School Diploma or GED required.
• CPCS or other credentialing certification required.
• Physician billing experience is preferred.

Responsabilidades

• Accurately complete and maintain provider applications for Initial and Re-credentialing/Renewals.
• Payer Enrollment/Credentialing for facilities or other entities.
• DEA/Licensure, Revalidations, CAQH processes.
• Update and maintain provider demographics in credentialing database.
• Request and maintain updated credentialing documents before expirations.
• Run regular reports and provide status updates to stakeholders.
• Participate in department projects and team meetings.
• Assist with other duties as assigned.

Conocimientos

Provider credentialing

Payer enrollment

CAQH management

Documentation accuracy

Educación

High School Diploma or GED

CPCS certification

Descripción del empleo

As a Credentialing Coordinator, you will be an essential part of the corporate business support team. You will have the opportunity to collaborate with professionals from diverse backgrounds and contribute to the strategic goals of our company. Your role will involve providing essential support to various departments, enabling them to focus on their core functions and drive overall success.

This position will report to the Credentialing Supervisor and performs day-to-day activities related to maintaining credentialing for providers including, but not limited to physicians, nurse practitioners, physician assistants and other billable providers. The credentialing coordinator will work to ensure accurate and timely credentialing and application process with all billable locations and contracted payers.

Key Responsibilities

• Accurately complete and maintain the following Provider applications (both Initial and Re-credentialing/Renewals) as required (completion of applications also includes conducting any necessary follow-up to ensure timely completion of process):
• Payer Enrollment/Credentialing
• Facility or other entities
• DEA/ Licensure
• Revalidations
• CAQH
• Completion of applications also includes conducting any necessary follow-up to ensure timely completion of process
• Update and maintain accurate provider demographic information in credentialing database timely and accurately
• Request and maintain updated credentialing documents from providers on an ongoing/as needed basis and prior to any expirations to ensure there is no lapse in coverage or provider status
• Run regularly scheduled reports to address any outstanding applications, issues, and expiring information.
• Provide status updates on all credentialing requests to Supervisor or other key stakeholders
• Participate in department projects as requested
• Attend team meetings, phone conferences, and training as needed; facilitate team meetings and phone conferences as needed
• Other duties and responsibilities as assigned

Qualifications

• Minimum of 2 years physician Credentialing experience
• High School Diploma or GED
• Certified Provider Credentialing Specialist (CPCS) or other credentialing certification
• Physician billing experience

Explore The Advantages Of Joining Our Team

• Enjoy competitive compensation and a wide range of benefits, including medical, dental, vision, low-cost virtual care, dependent and domestic partner coverage, 401K, and more, designed to support your well-being and financial security.
• Immerse yourself in a community united by a deep commitment to enhance mental health and revolutionize patient care.
• Embrace a journey of continuous learning, guided by seasoned professionals, fostering your career growth in a nurturing environment.
• Play a pivotal role in reshaping behavioral health, with your efforts directly improving patient lives.
• Thrive in an environment that celebrates collaborative success, driven by effective communication and unity.
• Receive comprehensive onboarding and ongoing educational resources, tailored to cultivate your talents and assure your triumph in your role.

Transformations Care Network is committed to fair and equitable compensation practices. The hourly compensation range for this role is $23 - $24. Actual compensation may vary based on licensure, experience, market-driven enhancements, and incentive opportunities available for this role. These ranges represent our current standard compensation practices and may be adjusted over time to remain competitive and aligned with organizational needs.

Transformations Care Network is an equal opportunity employer, committed to fostering an inclusive and diverse workplace.

Remote work eligibility: This position is open to candidates across the United States. However, based on TCN's current employment requirements, this role is not eligible to be performed in California, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Minnesota, Montana, New Jersey, New York, Oregon, or Puerto Rico. Eligible work locations are subject to change.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.