Medical Credentialing Coordinator

Everleap Fertility; Basking Ridge (NJ); Sur place; USD 48 000 - 62 000; Plein temps

Avantages offerts par ce poste

Medical, Dental, Vision Insurance

Paid Time Off & 8+ Paid Holidays

Company Paid Life Insurance

Long Term Disability & AD&D

Flexible Spending Accounts

Employee Assistance Program

401K Plan

Other voluntary benefits

Résumé du poste

Everleap Fertility is seeking an organized Credentialing Administrator to support providers’ insurance credentialing across our US clinics. You will manage CAQH profiles, identify missing information, and help maintain up-to-date provider files to ensure timely credentialing and enrollment.

The role emphasizes attention to detail, strong communication, and collaboration with billing to resolve credentialing issues while maintaining compliance with plan requirements.

Qualifications

• High school diploma, GED or equivalent.
• 1 year of credentialing experience with medical staff (preferred).
• Detail oriented with ability to prioritize tasks.
• Knowledge of medical credentialing and privileging procedures (preferred).
• Excellent verbal and written communication skills.

Responsabilités

• Create CAQH profiles for new providers in our US clinics.
• Identify discrepancies or missing information and 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.
• Ensure re-credentialing is completed timely to prevent lapse in enrollment.
• Respond to health plan provider inquiries.
• Work closely with billing staff to resolve denials or authorization issues.
• Maintain individual provider files with up-to-date information for credentialing.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.

Connaissances

Detail oriented

Communication skills

Prioritization

Credentialing knowledge

1 year credentialing experience

Formation

High school diploma, GED, or suitable equivalent

Description du poste

Everleap Fertility is seeking an organized Credentialing Administrator to support providers’ insurance credentialing across our US clinics. You will manage CAQH profiles, identify missing information, and help maintain up-to-date provider files to ensure timely credentialing and enrollment.

The role emphasizes attention to detail, strong communication, and collaboration with billing to resolve credentialing issues while maintaining compliance with plan requirements.