Managed Care Credentialing Coordinator

Department: 13257 Enterprise Corporate - Managed Health Clinical insights & Operations: Credentialing Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Looking for candidates with Managed Care credentialing experience (not provider enrollment). 100% remote position. Monday - Friday AM Shift. Pay Range: $24.10 - $36.15 Major Responsibilities: Manages enrollment of all employed and contracted AAMG providers by applying subject matter expertise skills based on specific hiring/contractual arrangements to decide appropriate credentialing variables, demographics and service line. Participate and/or request meetings with key contacts in AAMG to sort out appropriate credentialing route and enrollment processing of providers hired/contracted under a unique arrangement/contract. Collaborating with multiple departments/areas to streamline the above processes. Adheres to deadlines and scheduled managed care credentialing committees by tracking files through all stages. Day-to-day responsibility for maintaining proactive communication with internal and external individuals regarding credentialing, enrollment and government payor activation processes. Oversee receipt/review and processing of all practitioner demographic/specialty/other changes and resignation requests to be delivered to APP Network Management team for processing and distribution to commercial payers. Communicate regularly via phone, fax, or written correspondence with Credentials Verification Office, Hospital medical staff offices, contract entities, physicians and group practice offices. Provide direct support to Managed Care Credentialing coordinators in the processing of verifications and database maintenance of credentialing elements for new applicants and reapplicants. Also in tracking timely submission of recredentialing applications from AAMG Data entry and record keeping of ancillary practitioners employed by AAMG. Track expirables of licensure, insurance and board certification for all AAMG practitioners credentialed members of APP. Respond to internal/external questions and resolutions of problems relative to delayed, incomplete or problematic matters, specific to credentialing and provider enrollment according to established policies/procedures Represent team in medical group AAMG Acquisitions team, AAH Payer Activation, Advocate Intensivists and Office of APC weekly meetings. Education/Experience Required: Level of Education: High School Graduate Years of Experience: Four (4) years’ experience in administrative support position including database management. Knowledge, Skills & Abilities Required: Excellent communication, organizational and problem solving skills Advanced Proficiency in the use of Microsoft Office (Excel, Access, PowerPoint and Word) and credentialing software Knowledge of accrediting and regulatory agencies as related to the Medical Staff, including (but not limited to) Joint Commission, DNV, HFAP, CMS, OSHA, NCQA and State and Federal Law and other standards and regulations, and hospital and system-wide policies regarding licensed independent practitioners in the hospital setting required. Must have proven track record of effective interactions with physicians and other health care professionals Ability to work effectively and independently. Demonstrated ability to effectively manage multiple priorities License/Registration/Certification: None Physical Requirements and Working Conditions: This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.