Assistant Coordinator of Payer Credentialing

JOB SUMMARY

This position is responsible for all aspects of credentialing and re-credentialing of hospital, all physician practices, and providers for Saint Francis Healthcare System. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans accurately and timely. Maintains data in credentialing database and online systems. Ensure timely renewal of licenses, certification, and validations. This position reports directly to the Medical Staff Coordinator but will have a matrixed reporting relationship to revenue cycle leadership.

• Type:
  Full-time, 80 hours per 2 week pay period
• Typical hours:
  Monday-Friday, 8:00a-4:30p
• Education:
  
  High school graduate/equivalent- required
• Certification & Licensures:
  Certified Provider Credentialing Specialist- preferred
• Experience:
  
  Two to five years of payer credentialing experience with strong understanding and knowledge of Medicare, Medicaid, commercial payers, hospital & rural health specific requirements- required
• Excellent oral and written communication skills to communicate with diverse customer groups, including but not limited to, physicians, practice management and staff, vendors, and payers.
• Strong problem solving skills and attention to detail.
• Exceptional organization skills with intensely accurate follow through.
• Ability to work independently with minimal supervision.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• Compiles and maintains current and accurate data for hospital and providers.
• Compiles hospital and provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
• Maintains copies of current state licenses, DEA certificates, and other required credentialing documents.
• Maintains knowledge of current health plans and agency requirements for credentialing inclusive of Rural Health, Medicare, Medicaid and broad range of commercial payers.
• Sets up and maintains information in online credentialing databases and systems.
• Tracks license and certification expirations for hospital and all providers to ensure timely renewal, revalidation and re-credentialing.
• Ensures information remains current with all health plans, agencies and other entities.
• Works with insurance representatives to maintain accurate provider information in health plan directories.
• Performs other duties as assigned.

Saint Francis Healthcare System provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity or genetics. In addition to federal law requirements, Saint Francis Healthcare System complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

In compliance with the ADA Amendments Act (ADAAA) should you have a disability and would like to request an accommodation in order to apply for a currently open position with Saint Francis Healthcare System, please call  or email us at

Saint Francis Healthcare System supports the overall health and wellness of our colleagues by discouraging the use of tobacco and nicotine products. If you are selected for a career opportunity with our organization, and are a tobacco or nicotine user, you will be required to complete a tobacco/nicotine cessation program within your first year of employment. This program is free of charge as part of our Employee Assistance Program.