Credentialing Coordinator
- Maintain a strict degree of confidentiality in all areas relating to oral surgery and endodontic provider credentials, status and provider’s personal information.
- Review all documentation with HighFive Healthcare’s Vice President of Payor Relations prior to submitting physician’s documents to the Credentialing Committee pertaining to any adverse information during the application process.
- Ensure all provider enrollment paperwork is complete and submitted to the appropriate parties in a timely manner and documented.
- Follow up with insurers until the process is complete.
- Document location ID numbers issued.
- Preserve a spreadsheet for all data pertaining to fee schedules at each HighFive Healthcare location.
- Maintain provider documentation and update as necessary.
- Provide support regarding physician enrollment to our operations department, finance team, and the clinical operations officer.
- Respond promptly to any and all provider or third-party insurance payer requests or questions.
- Maintain electronic records of provider’s credentials, CAQH and insurer logins.
- Process all requests to update provider demographic or practice information and forward to the appropriate third parties as necessary.
- Communicate with the Vice President of Payor Relations and Regional Directors regarding any or all credentialing delays or issues.
- Research state specific credentialing applications and import for mapping.
- Bachelor’s degree from a four-year accredited university or college
- Have a minimum of 2 years credentialing experience
- Knowledge of Medicare and Medicaid is preferred
- CAQH experience is a BIG plus
- Knowledge of dental care and/or health care concepts and terminology preferred
- A high degree of organization, extreme attention to detail and follow through
- Above average interpersonal, verbal and written communication skills.
- Thorough knowledge of Microsoft Office applications, Adobe Acrobat DC and an overall degree of computer literacy
- Ability to work semi-autonomously and self-direct daily work
- A desire to explore and learn new things
- Medical, Dental, and Vision Insurance
- Life Insurance
- Short- and Long-Term Disability Coverage
- Paid Time Off (PTO)
- 401(k) Retirement Plan with Company Match
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