Medical Credentialing Coordinator- Hybrid

UNC Fertility; New Jersey; Hybrid; USD 28,000 - 30,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Paid Time Off & 8+ Paid Holidays

Company Paid Life Insurance, LTD & AD&

Flexible Spending Accounts

Employee Assistance Program

Retirement 401K Plan

STD, Life & AD&D Buy-up plans & more

Job summary

Everleap Fertility is hiring a Medical Credentialing Coordinator in Basking Ridge, NJ for a hybrid role. The position involves managing provider credentialing, CAQH profile creation, and ongoing enrollment with health plans.

You will maintain provider records, ensure timely re-credentialing, and collaborate with billing to resolve credentialing denials. The role requires attention to detail and strong communication, with compensation hourly in the $20–$22 range.

Qualifications

• 1 year of credentialing experience with medical staff (preferred).
• Extremely detail oriented and able to prioritize tasks accordingly.
• Knowledge of medical credentialing and privileging procedures and standards (preferred).
• 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 any denials or authorization issues related to provider credentialing.
• Maintain individual provider files to include up to date information needed to complete commercial payer credentialing and recredentialing.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.

Skills

Verbal communication

Written communication

Attention to detail

Education

High school diploma or GED

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Medical Credentialing Coordinator- Hybrid

Basking Ridge, NJ, US

17 days ago Requisition ID: 2819

Salary Range: $20.00 To $22.00 Hourly

Credentialing Administrator

We are looking to hire an organized credentialing administrator to assist us with administrative tasks pertaining to our practitioners' insurance credentialing. The credentialing coordinator will organize, maintain, and verify all aspects of the process, and maintain current files on practitioners

To be successful in this role you should ensure the currency and accuracy of all information.

• 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 any denials or authorization issues related to provider credentialing.
• Maintain individual provider files to include up to date information needed to complete commercial payer credentialing and recredentialing.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.
• 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.
• Knowledge of medical credentialing and privileging procedures and standards. (preferred)
• Excellent verbal and written communication skills.

Everleap Fertility offers a comprehensive full-time benefits package to all employees who work a minimum of 30 hours per week.

• Medical, Dental, Vision Insurance Options
• Paid Time Off & 8+ Paid Holidays
• Company Paid Life Insurance, Long Term Disability & AD&D
• Flexible Spending Accounts
• Employee Assistance Program
• Retirement 401K Plan
• Optional benefits including STD, Life & AD&D Buy-up plans & more.

Built on the legacy of RMA, Boston IVF, Conceptions, and six other leading North American fertility practices, Everleap Fertility brings together more than 200 physicians and embryologists across 60+ locations in the U.S., including 25 IVF laboratories focused on the next leap forward in reproductive medicine. Together, we have helped hundreds of thousands of patients build families for more than 40 years. As part of IVI Institute, Everleap Fertility contributes to a global community working together to advance the field and bring progress in reproductive medicine into patient care.

Equal Employment Opportunity Statement

Everleap Fertility is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind: Everleap Fertility is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at Everleap Fertility are based on business needs, job requirements and individual qualifications, without regard to race, color, religion and/or belief, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. Everleap will not tolerate discrimination or harassment based on any of these characteristics. Everleap encourages applicants of all ages.