Provider Enrollment Coordinator II (Credentialing)
Tasks
- Complete provider re credentialing within required timeframe
- Conduct monthly re credentialing mailings
- Coordinate provider applications with provider relations
- Ensure credentialing compliance with URAC NCQA and regulations
- Maintain confidentiality of provider information
- Perform primary source verification
- Perform secondary source verification
- Prepare credentialing committee roster for medical director approval
- Prepare provider issue files for medical director review
- Process credentialing committee files in Cactus
- Respond to customer calls and emails
- Review provider files before source verification
- Scan credentialing files and attach in Cactus
- Submit applications for auditing prior to credentialing committee
Perks/Benefits
- N/A
Skills/Tech-stack
Cactus | Credentialing | Customer Service | Managed care | Medicaid | Medical terminology | Medicare Managed Care | Microsoft Excel | Microsoft Word | NCQA | Primary Source Verification | Provider Recredentialing | Secondary Source Verification | Source verification | Technical writing | Time management | URAC
Education
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