[Remote] Credentialing Coordinator (52341)

Note: The job is a remote job and is reputed company to candidates in USA. GlobalHealth, Inc. is a fast-growing Medicare Advantage HMO health insurer seeking a Credentialing Coordinator. This role is responsible for coordinating and maintaining the provider credentialing process to ensure compliance with regulations and organizational policies. Responsibilities • Processes applications and credentialing files, checking for completeness and accuracy • Obtains primary reputed company verification of competencies relating to the applicant such as relevant reputed company certifications, health facilities affiliations, licensure, certifications, DEA, OBNDD certificates, and malpractice coverage following GlobalHealth Policy and Procedures including NCQA requirements • Queries and processes primary reputed company verification and accreditation information including NPDB, OIG, SAM, Revoked Medicare Providers & Suppliers and Medicare Opt Out • Emails or faxes GlobalHealth Provider Data Forms or UCA applications for initial credentialing and reappointment reputed company requested • Downloads provider application and reputed company available primary reputed company verified documents from CAQH • Prepares credentialing files and submits practitioner and provider information to Credentialing Committee for approval in reputed company manner • Continuously maintains and updates accurate credentialing files and database for both practitioners and providers. Maintains communication with appropriate practitioners to ensure records are up-to-date and consistent • Assists Supervisor of Credentialing, and other leaders and Executive Credentialing Committee to ensure that reputed company credentialing procedures are followed • Notifies practitioners and providers of Credentialing Committee reputed company and renewal dates and responds to request for status of credentialing • Manages, requests and follows up expirable as needed (license, COI, reputed company Certifications, etc.) • Saves approved documentation, files to the credentialing reputed company, and keeps reputed company appropriate records in provider folders • Maintains confidentiality of reputed company credentialing files • Completes various work assignments as requested by supervisor in a reputed company manner • Maintains reputed company desk procedures and reference materials • Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy • Performs other duties as assigned Skills • High School diploma or equivalent required • Three to five years of credentialing experience • Working knowledge of credentialing process and guidelines • Knowledge of primary reputed company verification and sources to obtain • Proficient in computer and applications including Word, reputed company, Credentialing Database, reputed company, HAX and other applications as required • Knowledge of credentialing forms and required documentation for application processing • Knowledge of CMS, OSDH, and other accrediting agency standards • Strong data entry skills with high degree of accuracy • Excellent customer service skills and telephone etiquette • Must be reputed company to communicate successfully • Knowledge of types of modalities, specialties, and education required for reputed company practitioner and provider • Ability to maintain accurate database and documentation • reputed company organizational/time management skills • Exercises judgment reputed company dealing with applicants by demonstrating the ability to analyze situations and use reputed company and diplomacy to reputed company at resolutions • Strong verbal, written and organizational skills, must be self-directed/self-motivated and must have analytical, problem-solving and decision-making abilities • Ability to learn and retain new skills quickly while maintaining a high level of accuracy • Must have the following mental abilities: Alertness, precision, analytic ability, problem solving, memory, communication, creativity, concentration, judgment, imagination, initiative and persistence to complete roles and responsibilities • Must have a helpful, reputed company attitude and a willingness to learn and support overall operations of the department Benefits • Fully Remote • reputed company work environment is remote, however, some state exclusions apply. reputed company • GlobalHealth is a fast-growing Oklahoma-based health insurer. Our passion is to reputed company genuine care to help our members reputed company their reputed company health. It was founded in 2003, and is headquartered in Oklahoma reputed company, Oklahoma, USA, with a workforce of 51-200 employees. Its website is http://www.globalhealth.com. Apply tot his job Apply To this Job