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administrative coordinator remote jobs near texas

Managed Care Credentialing Coordinator

Scottish Rite for Children -
Dallas, TX

Apply Now

Job Details

Full-time

Qualifications

Statistics
Data analysis reporting
Managed care
High school diploma or GED
Desktop applications
Productivity software
Healthcare software applications

Full Job Description

Our patients are our number one priority! We're committed to giving children back their childhood!

Job Posting Title:

Managed Care Credentialing Coordinator

Location:

Dallas - Hospital

Additional Posting Details:

Monday - Friday

Regular business hours: 40-hour work week

Remote - Must live in DFW Metroplex

Job Description:

Duties/Responsibilities

Assist leadership in the development, planning, implementation, review and revision of managed care credentialing processes, forms, related policies and procedures with regard to credentialing to stay current with Health Plans practice as well as accrediting and regulatory agency requirements (i.e., NCQA); maintain a working knowledge of such documents and keeps the medical staff updated on all changes
Facilitate, coordinate, prepare, monitor, maintain and implement all of the credentialing functions for medical staff and advanced practice professionals, in a timely manner, such as: managed care credentialing applications for network participation re-credentialing with health plans, monitoring, including procurement of applications and required supporting documents
Ensure all expirables are reviewed, obtained, maintained and managed by tracking, documenting: licensures, certifications, specialty certification, and malpractice insurance information prior to their expiration dates and other expirables as required; notify appropriate medical and administrative leadership staff prior to expiration so that required documents can be secured and updated or required intervention or actions can be accomplished in a timely manner
Originate or collect, update and maintain: all required documentation and records and the managed care medical staff credentialing software databases as appropriate
Maintain reporting and communication with hospital leadership as to credentialing status of hospital, physician staff, and advanced practice professionals
Regularly monitor payer websites to ensure accuracy of Scottish Rite for Children and providers in payer online tools (i.e., provider manuals); address with payer to correct any deficiencies
Develop annual goals and objectives for the Managed Care Credentialing function in concert with the organization’s strategic plan
Develop, maintain, and apply working knowledge of relevant federal and state laws and regulations and accreditation standards/agencies and other regulatory requirements (i.e., NCQA)
Support the General Counsel in handling of legal matters for Scottish Rite, assist with special projects and help maintain files in the Office of General Counsel
Provide professional support to the management staff in partnership with other support staff
Attend meetings and take minutes for these meetings as requested
Assist with miscellaneous duties and special projects as assigned

Required Skills/Abilities

High school diploma or equivalent required
Associate degree preferred
Minimum 2 years of Medical Staff or Managed Care Credentialing Coordinator experience; in a hospital, clinic, or health plan setting is preferred
Certification through the National Association of Medical Staff Services (NAMSS) as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Staff Management (CPMSM upon hire is preferred. Otherwise, certification must be obtained within 2 years of hire or 2 years of eligibility per NAMSS requirements, as applicable
Proficient in computer applications (e.g., Windows, Microsoft Office, internet browsers, medical staff/credentialing software databases, etc.)
Knowledge of standards in managed care credentialing practiced, health plan credentialing requirements, statistics, data collection, analysis and data presentation
Excellent interpersonal communication, organizational and problem-solving skills

#P2

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Refine Your Search

administrative coordinator remote jobs in texas

Managed Care Credentialing Coordinator

Administrative Assistant Project Coordinator

Clinical Administrative Coordinator

Administrative Coordinator

Billing Coordinator (Data Entry)

Billing Operations Specialist

Patient Care Coordinator

Business Operations Coordinator

Payroll Coordinator II - REMOTE

Escrow Operations Coordinator (Remote- US)

Administrative Coordinator - Professional Education & Events (BIOTRONIK Neuro)

Administrative Coordinator - Professional Education & Events (BIOTRONIK Neuro)

Placement Coordinator

Project Coordinator II

Case Management Administrative Assistant

Healthcare Coordinator

Senior Coordinator, Administrator

Sales Administrator

Land Solutions Program Coordinator, Remote

Business Coordinator, Internal Medicine (Partial Remote)

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