Located in the heart of Phoenix, Ariz., St. Joseph's Hospital and Medical Center is a 586-bed, not-for-profit hospital that provides a wide range of health, social and support services with special advocacy for the poor and underserved. St. Joseph's is a nationally recognized center for quality tertiary care, medical education and research. It includes the internationally renowned Barrow Neurological Institute, the Muhammad Ali Parkinson Center, the Norton Thoracic Institute, a campus of Creighton University's Medical School and the first Level I Trauma Center in Arizona verified by the American College of Surgeons. U.S. News & World Report routinely ranks St. Joseph's among the best hospitals in the United States for neurology and neurosurgery. For more information please visit our website at https://www.dignityhealth.org/arizona/locations/stjosephs.
The Credentials Coordinator is responsible for coordinating the credentialing, re-credentialing and payer enrollment process for Barrow Neurological Institute and contracted providers in accordance with the Health Plan's Delegated Credentialing Agreements, Physician Billing Services policies and procedures, industry best-practices, and regulatory requirements. Responsible for the daily credentialing operations, including resolution of non-responsive providers, and working with various clinic managers and the hospital medical staff office to ensure successful and timely completion of the delegated credentialing and re-credentialing process.
Three (3) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment.
High School diploma/ GED
Proficient with CACTUS Software, or similar credentialing system Intermediate Microsoft programs skills (MS Word, Excel, Power Point). Works well under stress and with shifting priorities.
Builds successful customer relationships excellent oral and written communication skills are essential.
Knowledge of NCQA standards and Joint Commission standards.
Knowledge of commonly-used concepts, practices, and procedures used in health care and physician credentialing.
Five (5) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment.
Bachelor's degree or Certified Provider Credentialing Specialist (CPCS)
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