The Credentialing Coordinator will build and maintain a successful working relationship between LHI and network practitioner to ensure a stable practitioner network. They will be facilitating successful activation and maintenance of practitioner by performing initial credentialing, ongoing monitoring and re-credentialing process of all required network practitioners in accordance with industry standards. The Credentialing Coordinator will communicate daily with outsourced vendors, healthcare facility point of contact / professionals, as well as internal staff to maintain a detailed and compliant practitioner file credentialing system for various company contracts. As a part of the Credentialing Team, they ensure the practitioner network meets or exceeds quality, contract, and credentialing expectations to foster continued quality improvement and risk management efforts.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Identify and document credentialing, compliance and contract requirements as the enroll in LHI’s network to include creation and maintenance of practitioner record within database
- Initiate, retrieve, verify, and follow up on all credentialing applications and content needed for LHI’s practitioner network. Ensure applications are complete, data integrity is intact within database to meet requirements for primary source verification
- Monitor accurate re-credentialing of practitioners on a three-year cycle
- Act as the liaison between the practitioner network and internal departments to troubleshoot issues or answer any questions/concerns
- Ongoing monitoring of credentialed network for accuracy or any change in status to include regular internal practitioner record audits
- Submit appropriate practitioner records to CVO (Certified Verification Organization). Retrieve and review CVO file as completed
- Submission of background checks as required on credentialed practitioners to contracted vendor. Retrieval and review of the reports as part of the credentialing packet
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Associate’s Degree (or higher) in Health Information Technology, Business, or related field and 1+ year experience in credentialing / healthcare – OR – a combination of college education, credentialing experience, healthcare experience, and / or military experience totaling at least 3 years
- Intermediate to Expert experience using Microsoft Office Suite including Word (ability to create, edit, save, and send documents), Excel (ability to create, edit, save, and send spreadsheets), and Outlook (ability to send / receive emails)
- 6+ months of experience using phone and computer as your primary work tools
The work schedule will be either 1 st or 2 nd shift ( 1p-10p CST) and include at least one weekend day per week.
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
- Healthcare terminology experience
- Certified Provider Credentialing Specialist (CPCS) through the National Associate Medical Staff Services
- National Career Readiness Certificate
- Familiarity with NCQA credentialing standards
- Knowledge of practitioner credentialing and primary source verification of medical/dental licensure
- Database experience and working with electronic files / documents
UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non-clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.
You can learn more about all we are doing to fight COVID-19 and support impacted communities: click here .
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado Residents Only: The hourly range for Colorado residents is $15.00 to $25.19. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, in addition to your salary, UnitedHealth Group offers the following benefits for this position, subject to applicable eligibility requirements: health, dental and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term and long-term disability insurance; business travel accident insurance; employee assistance program; paid time off; and employee-paid critical illness and accident insurance.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
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