Top 9 Credentialing coordinator Jobs in Pennsylvania

CHOPPA Enrollment Coordinator
Children’s Hospital of Philadelphia —Philadelphia, PA
- $25.50 - $31.85 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Analysis skills
Quick Apply
Enrollment Coordinator
Wellspan Health —York, PA
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Paid parental leave
- Paid time off
6d
Administrative Coordinator, Medical Affairs, Credentialing Verification Office, Full Time, Bethlehem
St. Luke's University Health Network —Bethlehem, PA
- Full-time
- Mid-level
- Office
- High school diploma or GED
13d
Credentialing Coordinator - Revenue Cycle
UPMC —Pittsburgh, PA
- $20.20 - $32.01 an hour
- Full-time
- Mid-level
- High school diploma or GED
- 2 years
Medical Staff Credentialing Coordinator
Thomas Jefferson University and Hospitals —Abington, PA
- Full-time
- Hospital
- Medical office experience
- Mid-level
- AD&D insurance
- Disability insurance
Provider Services Coordinator
Penn Medicine —Bala-Cynwyd, PA
- Full-time
- Mid-level
- Administrative experience
- High school diploma or GED
- Tuition reimbursement
Quick Apply
Credentialing Coordinator
Wellspan Health —York, PA
- Full-time
- Computer literacy
- Mid-level
- High school diploma or GED
- Paid parental leave
- Health insurance
3h
Credentialing Coordinator QI
Elwyn —Media, PA
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Paid training
- Health insurance
Quick Apply
8d

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CHOPPA Enrollment Coordinator

Children’s Hospital of Philadelphia -
Philadelphia, PA

Quick Apply

Job Details

Full-time
$25.50 - $31.85 an hour

Qualifications

Medicare
High school diploma or GED
Medicare regulations
Centers for Medicare and Medicaid Services (CMS)
Medicaid regulations
Medicaid
Productivity software

Full Job Description

SHIFT:

Day (United States of America)

Seeking Breakthrough Makers
Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.
At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.

CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means.

A Brief Overview
This role is responsible for gathering and verifying healthcare practitioner information and tracking all compliance information related to the enrollment and re-credentialing process. This includes processing all incoming applications to ensure accuracy at completion and that all required licensing and certification documentation is present, as well as all additional required documentation. All necessary file maintenance functions, including updating service locations, rendering provider information; licensure and ownership information is also a function of this position.

What you will do

Provides reviews and prepares new hire enrollment packets for accuracy, completeness and timely submission to the payers and maintains current provider information in order to ensure timely reimbursement of payment for services. Performs follow-up with the physicians to request necessary documentation for the application/re-credentialing process (Renewal reminders must be sent 30 days prior to the expiration date).
Maintains a working knowledge of payers’ processes and updates and ensures that the physician database and NPPES system is kept accurate and current. CAQH re-attestation to occur every 120 days for all providers.
Maintains files, scans credentials and monitors expiration dates and notifies administrators and Enrollment Manager of deadlines.
Initiates phone calls, generates letters and other correspondence as required for follow up with payers to ensure timely receipt of provider participation effective dates and numbers (goal is within 60 days of payer receipt date of the application). Assures that all contacts and discussion with payers are documented and maintained, as well as copies of emails and/or written correspondence sent to third party payers, for future reference.
Reviews and provides research results to the Billing Department to assist with claims issue resolution.

Education Qualifications

High School Diploma / GED Required
Associate's Degree Preferred

Experience Qualifications

At least two (2) years Previous experience with insurance verification, billing and/or provider relations Required or
At least two (2) years medical insurance verification/provider relations. Required

Skills and Abilities

Working knowledge of insurance billing/provider operations within a large healthcare organization. (Required proficiency)
Knowledge of Medicare and Medicaid policies and procedures. (Required proficiency)
Basic proficiency with MS Word, Power Point, Excel computer programs (Required proficiency)
Knowledge of the ECHO, NAVINET and CAQH systems (Required proficiency)
Solid critical thinking / problem-solving skills (Required proficiency)
Solid analytical and organizational skills. (Required proficiency)
Ability to collaborate with stakeholders at all levels (Required proficiency)

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.
EEO / VEVRAA Federal Contractor | Tobacco Statement

SALARY RANGE:

$25.50 - $31.85 Hourly

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.

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Refine Your Search

credentialing coordinator jobs in pennsylvania

CHOPPA Enrollment Coordinator

Enrollment Coordinator

Administrative Coordinator, Medical Affairs, Credentialing Verification Office, Full Time, Bethlehem

Credentialing Coordinator - Revenue Cycle

Medical Staff Credentialing Coordinator

Provider Services Coordinator

Credentialing Coordinator

Credentialing Coordinator QI

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