Senior Credentialing Specialist — NCQA & Compliance Lead

Lurie Children's; Chicago (IL); Hybrid; USD 29,000 - 45,000; Full time

Benefits offered by this job

Medical, dental and vision insurance

Paid time off and holidays

403(b) with 5% employer match

Job summary

Ann & Robert H. Lurie Children’s Hospital of Chicago is seeking a Credentialing Coordinator Sr to support the Credentialing team in primary source verifications, credentialing and recredentialing for FPP clients, and to ensure NCQA and regulatory compliance.

The role requires 2 years of credentialing experience or a BA, CPCS eligibility, and strong data management skills with Excel/Access experience. This is an on-site role located in Streeterville, Chicago.

Qualifications

• BA preferred or minimum two years experience in credentialing and recredentialing process.
• Must be eligible for certification by National Association of Medical Staff Services as a Credentialing Specialist (CPCS).
• Must have experience with an NCQA audit.

Responsibilities

• Manages credentialing and re-credentialing processes according to NCQA Standards, State and Federal guidelines, FPP Policies and Procedures, and FPP Bylaws.
• Coordinates materials for FPP Credentialing Committee; assists Director of Credentialing with FPP Credentialing and Recredentialing Policies and Procedures.
• Follows through with Credentialing Committee approvals; adheres to State recredentialing cycles.
• Responsible for credentialing and recredentialing for FPP clients; for new and existing FPP physicians.
• Develops billing invoices and calculates receivables for FPP clients.

Job description

Ann & Robert H. Lurie Children’s Hospital of Chicago is seeking a Credentialing Coordinator Sr to support the Credentialing team in primary source verifications, credentialing and recredentialing for FPP clients, and to ensure NCQA and regulatory compliance.

The role requires 2 years of credentialing experience or a BA, CPCS eligibility, and strong data management skills with Excel/Access experience. This is an on-site role located in Streeterville, Chicago.