What Managed Care contributes to Cardinal HealthPractice Operations Management oversees the business and administrative operations of a medical practice.Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other activity as it relates to payer interaction.The Credentialing Coordinator is responsible for ensuring active credentialing status is maintained with all contracted payors for all Centers' Physicians and Mid-Level Providers. The position is also responsible for ensuring that all expiring documents (license, DEA, CDS, Boards, health documents, Collaborative Agreements, etc.) are updated and active for all markets and clinicians.This is a remote opportunity. Preference is for someone who is currently located on Eastern Standard Time.Responsibilities
Coordination of initial or recredentialing for all Centers, Physicians and Mid-Level Providers.
Develop, maintain and monitor a credentialing database with applicable effective dates, location and lines of business to ensure an active and accurate status among contracted payors.
Ensure licenses and certifications and all expiring documents are accurate and active among all markets.
Maintain and monitor a database of licenses and certification, to ensure compliance among all markets.
Complete documentation required to obtain hospital privileges for physicians, as necessary.
Collaborate with leadership to ensure that appropriate documentation is submitted for government payors timely.
Meets regularly with Associate Director, Credentialing to update on progress and status of credentialing issues.
Meets regularly with Team to discuss status of payer/credentialing related issues, processes and collaborate.
Resolves credentialing and payer issues as necessary.
Develop accessible files for credentialing and licensing by provider and center, including monthly updates on status.
Updates and uploads all appropriate documentation to Provider & Center Files and Credentialing Database
Meets assignment due dates.
Regular attendance and punctuality is required.
Contributes to team effort by accomplishing related results as needed.
Ensures that all processing and reporting deadlines are consistently achieved.
Performs any other functions as required by management.
Qualifications
Ability to work a flexible schedule (including overtime, and weekends), as necessary.
At least two (2) years of experience of Credentialing experience, or in a managed care industry.
Excellent phone/customer service skills.
Specific knowledge of payer credentialing and provider enrollment process
Ability to work independently and as part of a team.
Experience with Excel spreadsheets and Microsoft Word documents and Credentialing Database(s)
General knowledge of the healthcare environment and payer issues, particularly billing and collections
High School Diploma or equivalent
Preferred Skills
Knowledge of basic medical terminology
What is expected of you and others at this level
Applies acquired job skills and company policies and procedures to complete standard tasks
Works on routine assignments that require basic problem resolution
Refers to policies and past practices for guidance
Receives general direction on standard work; receives detailed instruction on new assignments
Consults with supervisor or senior peers on complex and unusual problems
Pay rate: $20 per hourBonus eligible: NoBenefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
Medical, dental and vision coverage
Paid time off plan
Health savings account (HSA)
401k savings plan
Access to wages before pay day with myFlexPay
Flexible spending accounts (FSAs)
Short- and long-term disability coverage
Work-Life resources
Paid parental leave
Healthy lifestyle programs
Application window anticipated to close: 4/14/2025 if interested in opportunity, please submit application as soon as possible.Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.To read and review this privacy notice click here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)
