Hybrid Medical Credentialing Coordinator

IVI America; Basking Ridge (NJ); Hybrid; USD 28,000 - 30,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

Paid time off & 8+ holidays

Company paid life insurance, LT.dis &/

401K plan

Flexible Spending Accounts

Employee Assistance Program

Job summary

IVI America seeks a Credentialing Administrative Assistant in Basking Ridge, NJ, to support administrative tasks for practitioner insurance credentialing. This full-time, hybrid position involves creating CAQH profiles, updating provider data, and coordinating with health plans and billing to ensure timely credentialing and enrollment.

The role requires attention to detail, strong verbal and written communication, and at least 1 year of credentialing experience.

Qualifications

• High school diploma, GED, or suitable equivalent.
• 1 year of credentialing experience with medical staff (preferred).
• Extremely detail oriented and able to prioritize tasks accordingly.
• Excellent verbal and written communication skills.

Responsibilities

• Create CAQH profiles for all new providers in our US clinics.
• Identify discrepancies or missing information and conduct follow-ups.
• Update and re-attest each provider profile quarterly and/or as needed.
• Complete and submit initial applications to commercial insurances for participation.
• Notify health plans of provider information/demographical updates and changes as well as practitioner status changes.
• Update demographic information and provide supporting documents to outside stakeholders, such as commercial managed care plans.
• Ensure re-credentialing is completed timely to prevent any lapse in enrollment.
• Respond to health plan provider inquiries.
• Work closely with the billing staff to identify and resolve denials or authorization issues related to provider credentialing.
• Maintain individual provider files to include up to date information needed for credentialing.

Skills

Detail oriented

Verbal communication

Written communication

Credentialing experience

Education

High school diploma

Job description

IVI America seeks a Credentialing Administrative Assistant in Basking Ridge, NJ, to support administrative tasks for practitioner insurance credentialing. This full-time, hybrid position involves creating CAQH profiles, updating provider data, and coordinating with health plans and billing to ensure timely credentialing and enrollment.

The role requires attention to detail, strong verbal and written communication, and at least 1 year of credentialing experience.