Credentialing Intake Coordinator

Credentialing Intake Coordinator

Department : Ops - Credentialing

Employment Type : Full Time

Location : 1600 Corporate Center Dr., Monterey Park, CA 91754

Reporting To : Natalie Fandel

Compensation : $18.00 - $20.00 / hour

Description

Our Credentialing Intake Coordinator oversees the intake and initial processing of credentialing applications for medical providers. This role ensures all necessary documentation is reviewed, verified, and accurate, facilitating a smooth credentialing process.

What You'll Do

• Review and process healthcare providers' credentialing applications to ensure compliance with health plan participation requirements.
• Verify providers' professional qualifications, including education, licensure, and certifications.
• Maintain and update credentialing records for all providers within the health plan network.
• Submit credentialing applications to health plans for review and approval.
• Monitor re-credentialing timelines, ensuring timely renewal of certifications, licenses, and memberships.
• Ensure compliance with federal, state, and health plan-specific regulations and policies.
• Collect required documentation from providers, including diplomas, licenses, certifications, and malpractice insurance.
• Address and resolve discrepancies or issues encountered during the credentialing process.
• Protect the confidentiality of sensitive provider and patient information.
• Assist with audits and respond to health plan inquiries regarding credentialing status.
• Collaborate with internal departments to resolve credentialing-related issues and maintain accurate data.

Qualifications

Preferred Qualifications

Environmental Job Requirements and Working Conditions

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