Credentialing Coordinator I

EVPS - Beachwood, OH3.6

Full-time
Overview
Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women’s and children’s health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services. As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia.

If you are looking for a stable, fast-paced, growing company in the healthcare industry that is committed to innovation, excellence and integrity, then this may be a great next step in the advancement of your career.

We currently have an exciting opportunity available for an experienced Credentialing Coordinator II. This role is responsible to ensure that all providers are processed/credentialed prior to start date (i.e. Credentialing support of Employment, Hospital, and Licensing Applications). Maintain communication with Internal/External customers (MSO’s, Client Service, State Boards) ensuring accuracy of the Applications (its Affiliates, Managed Entities etc.) and creating efficiency for the on-boarding process.

Responsibilities
ESSENTIAL DUTIES AND RESPONSIBILITIES

Complete and review with accuracy and thoroughness all new hires and additional locations/boards for credentialing and re-credentialing applications within timeframe
Responsible for notification to appropriate parties once received
Responsible ensure MSO (Medical Staff Offices), credentialing database is updated and current
Ensure primary source verifications occur for internal processing as well as external customers (i.e. MSO’s & State Boards)
Provide timely follow-up to obtain documentation required
Credentialing (within 180 days) & re-credentialing within 36 months
Coordinate internally to ensure complete information is received
Ensure credentialing & re-credentialing is processed in accordance with NCQA and company standards
Assist and prepare for NCQA audit
Additional projects as needed
Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs.
Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment or other prohibited activities in accordance with the reporting policies of the company
Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so
Qualifications

Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Good organizational skills
Communicate and work well in a team environment
Meet established production and quality goals/metrics
Follow up in a timely manner on open items
Able to effectively prioritize work on a daily basis

Education/Experience:
High School Diploma or General Education Degree (GED) and 2 or more years of related experience

Computer Skills:
To perform this job successfully, an individual should have knowledge of:

Microsoft Office Suite
Credentialing Software

Certificates and Licenses:
Certified Provider Credentialing Specialist (CPCS) through National Association of Medical Staff Services a plus

If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! We offer a competitive salary and a comprehensive benefits package.

Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify.

Envision Physician Services is an Equal Opportunity Employer.

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