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Credentialing Coordinator - Revenue Cycle

Company: Catholic Health Initiatives
Location: Lincoln
Posted on: March 28, 2020

Job Description:

Credentialing Coordinator - Revenue CycleLocation: LINCOLN, NEBRASKA, UNITED STATESNew Requisition #: 2020-R0280644Post Date: 7 hours agoPosition Type: RegularScheduled Hours per 2 week Pay Period: 80Primary Location: NE > LINCOLN > THE PHYSICIAN NETWORKYour time at work shouldbe fulfilling. Rewarding.Inspiring. Thats what youll find when you join one of our non-profit CHIfacilities across the nation. Youll find challenging, rewarding work every dayalongside people who have as much compassion as you. Join us and together wellcreate healthier, stronger communities. Imagine your career at Job ResponsibilitiesResponsibility for credentialing and re-credentialing of Physicians, AdvancedPractice Clinicians, Ancillary Providers and Facilities. Ensures optimumutilization of the managed care credentialing process through proactivecoordination and tracking of all information in the credentialing files of allproviders in CHI Health Partners as well as being responsible and accountablefor maintenance of credentialing related information. Presents with positiveand cooperative image with internal and external customers and contacts.Additional responsibilities for this health care role include:

  • Managescredentialing and re-credentialing process for CHI Health Partners (CHP).
  • Coordinatesprovider CHP packets and receipt of credentialing files from Med StaffServices.
  • Develop,update and coordinate the implementation of Credentialing policies andprocedures for approval by the Clinical Integrated Network (CIN) and finalapproval CIN Board, as needed.
  • Ensurescompliance and adherence to NCQA standards of function and responsibilityrelates to credentialing for CHP.
  • Workswith provider offices and facilities to attain correct information.
  • Responsiblefor preforming verification by query to the National Practitioner Data Bank(NPDB),
  • Office of Inspector General (OIG), System forAward Management (SAM), Medicare Opt Out and State
  • Exclusions and Sanctions for Nebraska andIowa.
  • 7. Completes process of credentialing newproviders by sending the welcome letter and contract. Runs new provider reportto send to all managed care payer, recredentialed providers receive a letter
  • showingthe file is up to date. This all happens after they have been approved by theCIN Council and Board.
  • 8. Coordinates and prepares for payer auditsof CHP credentialing files for those networks which
  • Delegatecredentialing to CHP. Job RequirementsHigh School diploma orequivalent required Associates degree in business or related field orequivalent. Combination of academic and/or professional experience required.Candidates without an Associates Degree must possess 1-3 years relatedexperience.Excellentresearch, verification skills and attention to detail. Ability to work withproviders, office staff and hospital administrators. Proficient in wordprocessing and excel spreadsheets. This individual must maintain strictconfidentially, communicate effectively, and work independently.Join us at Catholic Health Initiatives, and become a part of ourfaith-based health system. Additional Information
    • Requisition ID: 2020-R0280644
    • Schedule: Full-time
    • Market: CHI Health About UsWe are excited to share that CHI was named as one of Americas Best Employers 2019, by Forbes. Clickhereto learn more.Chances are, youre here because youre looking for a career offering greater opportunity, challenge and fulfillment. Were confident youll find all three at CHI. As one of the nations largest nonprofit health systems, we offer a wealth of careers across more than 101 hospitals in 18 states. Our faith-based health system welcomes you to share in our mission of building healthier communities, whether as a surgeon in the operating room or an administrator in a conference room. When you work in a supportive environment with like-minded professionals, wonderful things happen. Learn MoreEqual Opportunity EmploymentConsistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic

Keywords: Catholic Health Initiatives, Lincoln , Credentialing Coordinator - Revenue Cycle, Other , Lincoln, Nebraska

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