Credentialing Coordinator

Job ID
2020-95463
Employment Type
Full Time
Department
Clinic Administration
Hours / Pay Period
80
Facility
Dignity Health Medical Group Arizona
Shift
Day
Standard Hours
M-F 8-5
Work Schedule
8 Hour
Location
AZ-Phoenix

Overview

Hello humankindness 

Dignity Health Medical Group is the employed physician group of Dignity Health Arizona. Dignity Health Medical Group (DHMG) employs approximately 200 providers and 500 support staff that cover a wide variety of specialties. The medical group has had tremendous success over the past few years and now provides more than 73 subspecialty services.  The physicians provide clinical services in their areas of specialty and many serve in pivotal academic, research and leadership roles.

 

DHMG is also heavily involved in preparing tomorrow's healthcare providers. DHMG has 84 medical school students and approximately 200 residents and fellows throughout the 25 academic programs.  Clinical services are complemented with translational and bench research to augment medical education for residents and students. 

 

The mission of Dignity Health Medical Group is consistent with Dignity Health's mission and St. Joseph's guiding principles with a focus on innovative clinical care and the pursuit of excellence through scholarly activities. As part of the Dignity Health hospital system, DHMG has full access to the staff and all facilities on our hospital campuses. This unique relationship with our hospital allows Dignity Health Medical Group to provide its patients with state-of-the-art patient services including care of the poor and disenfranchised.

 

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Responsibilities

SUMMARY - The Credentials Coordinator is responsible for coordinating the credentialing, re-credentialing and payer enrollment process for the St. Joseph's Medical Group and contracted providers in accordance with the Health Plan's Delegated Credentialing Agreements, PBS Department 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 recredentialing process.

Qualifications

MINIMUM

High School Diploma/GED

Three (3) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment. 

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.

 

PREFERRED 
Five (5) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment

Bachelor's degree preferred. Degree, plus at least five (5) years of experience

 

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