Healthcare Credentialing & Contracts Coordinator

Socket.dev; United States; On-site; USD 42,000 - 68,000; Full time

Benefits offered by this job

Health Coverage

PTO & Holidays

401(k) Plan

Employee Assistance Plan

Job summary

PACS is seeking a Specialist/Coordinator to maintain contracting platforms for facilities and support the Managed Care Department with Health Plan applications, credentialing, and access to contracts.

You will manage credentialing statuses, audit licenses, register facilities with SAM.gov, and coordinate with MNS for authorization and claims access. Additional contracting support and related duties are included.

Responsibilities

• Credentialing: maintain credentialing status of Skilled Nursing Facilities with Health Plans by submitting credentialing applications and required documentation timely.
• Audits of certifications and updates to Health Plans to ensure compliance.
• Assist Managed Care Department with Health Plan contracting: credentialing, filing/loading contracts, and notifying facilities.
• Register and renew facilities with SAM.gov; maintain data records to track status.
• Maintain Facility profiles and documents in Credentialing Point; assist with MNS training setup for authorization and claims access.
• Coordinate with MNS on loading new or revised credentialing documents.
• Complete Health Plan Credentialing documents in Credentialing Point.
• Provide contracting support and perform all other duties as assigned.

Job description

PACS is seeking a Specialist/Coordinator to maintain contracting platforms for facilities and support the Managed Care Department with Health Plan applications, credentialing, and access to contracts.

You will manage credentialing statuses, audit licenses, register facilities with SAM.gov, and coordinate with MNS for authorization and claims access. Additional contracting support and related duties are included.