Credentialing and Enrollment Coordinator (FT, Days)

Job description

Job Details Responsible for the credentialing and enrollment of Jefferson Medical Group (JMG) physicians with contracted commercial and government payers. Works with assigned department staff to ensuring required documentation is obtained and complete for a smooth enrollment process. Job Description: Essential Functions: Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. Prepare initial and recredentialing plan applications for non-delegated providers. Follow up and Track applications submitted to payers using credentialing software. Connect with payers regarding status of applications, correcting issues and resubmitting timely as needed Process changes and terminations of providers timely Investigate provider claim holds and release claims once confirmation of payer setup is complete. Maintain the integrity of physician and practice information as well as outside databases (CAQH, Availity, etc.) Completion of other projects as assigned to support the department. Competencies (Knowledge, Skills, and Abilities Required): - Knowledge of criteria for health plans payer enrollment. Experience with CMS/PECOS provider enrollment. - Ability to mu...