Credentialing Coordinator in Westmont, IL at Athletico

Date Posted: 11/9/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Westmont, IL
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    11/9/2019

Job Description



Mission Statement and Core Values
Athletico’s sole purpose is to provide exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury. This is accomplished through building on our core values of patient/client satisfaction, accountability, teamwork and continuous improvement, which are the foundation for our unique culture.



Responsibilities

Position Summary

The Credentialing Coordinator works to ensure all active therapists have completed applications and credentialing/ re-credentialing information on file with applicable contracted payers. The coordinator reviews applications, prepares verification letters, and contacts clinical staff and insurance carriers to complete applications. The position requires coordination of contract information between the Business Development Manager, Payor Relations Manager, Reimbursement Manager, local Practice Managers, and Clinical staff.

Essential Duties and Responsibilities

  • Maintain credentialing database for professional, clinical staff. Obtain all necessary credentialing information and complete standard applications for new hires and new contracts, per payor specifications.
  • Maintain location listings and directories for local markets and national lists, providing updates to payers as needed.
  • Complete applications and obtain necessary documentation and signatures from clinical staff.
  • Copy agreements and distribute to Payor relations, reimbursement as needed and file in master payer binders.
  • Mail agreements and follow-up until counter-signed agreement is returned.
  • Provide payors with updates related to new locations, periodic roster updates, and all official notices (address change, remittance change, change in ownership, reporting of malpractice claims, etc
  • Complete letters, applications, and documentation related to credentialing in an accurate and timely manner.
  • Inform and update Payor Relations and reimbursement with newly assigned and or revised provider numbers.
  • Assist with creation of credentialing tools for MSA business, including written procedures, forms, and exhibits for P&P, as needed.
  • Other duties as assigned by management

Additional Duties and Responsibilities

  • Perform other duties as required


Qualifications

Job Requirements/Specifications

Education and Experience: The requirements listed below are representative of the knowledge, skill, and/or ability required.

  • Must have at least a high school diploma
  • Excellent writing skills
  • Computer skills required
  • Proficient in Microsoft Office required
  • Be comfortable with high volume work load
  • Be comfortable with fast paced work environment
  • Must be team-player
  • Ability to prioritize and multi-task
  • Be organized and self-directed
  • Prior credentialing experience preferred
  • Knowledge of CAQH/Proview, NPPES/I&A Management System and PECOS preferred
  • Knowledge of Medicare’s enrollment process, including enrollment forms preferred

Essential Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactory. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Demonstrated ability to consistently communicate a clear understanding of patients/clients expectations and adapt as appropriate to exceed their needs
  • Proven skill to provide patient care/service that exceeds expectations
  • Demonstrated ability to take ownership for one's own actions or decisions
  • Proven skill to foster a sense of teamwork and cooperation while working with others
  • Demonstrated ability to analyze and audit data and make process improvement recommendations
  • Proven ability to handle multiple projects simultaneously in a team based environment

Language Skills

  • Ability to read, write and speak English proficiently

Physical Demands: The physical demands describe here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

  • Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus
  • While performing the duties of this job, the employee is regularly required to talk and hear
  • Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to: remaining seated for periods of time to perform computer based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.)
  • Frequently required to stand, walk, sit, use hands to feel, and reach with hand and arms
  • Occasionally lift and/or move up to 20-25 pounds
  • Fine hand manipulation (keyboarding)
  • Local travel required

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Internal office

  • The noise level in the work environment is usually low

Athletico provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.   This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.