Location: Orange, California US
Job Number: 1569
Position Title: Credentialing Coordinator
The Credentialing Coordinator is responsible for credentialing activities to ensure that Alignment Healthcare has a provider network of the highest quality. The Credentialing Coordinator will work with the credentialing team on all aspects of credentialing and re-credentialing including preparing and maintaining reports, communication with providers and internal departments as well as performing database entry of provider and facility information to ensure compliance with regulatory and accreditation requirements.
(May include but are not limited to)
- Maintains department files in an organized, accurate, secure manner
- Send out application receipt letter to providers
- Process outgoing and incoming requests for credentialing and credentialing inquiries
- Assist the Credentialing Specialists with ongoing monitoring activities
- Assists with coordinating credentialing files for Committee review
- Assist with processing Committee review results including Minutes, system updates, notification letters to providers and internal staff
- Responsible for health plan provider-related communications.
- Responsible in updating credentialing provider roster database.
- Know how to process provider applications for hospital privileges for internal staff.
- Maintains good communication with office staff, CVO, hospital staff and physicians. maintains excellent team working skills and working outside of job description if necessary
- Respond to internal and external customer inquiries regarding credentialing status
- Perform other duties, as required or assigned
This job has no supervisory responsibilities
- Minimum Experience:
- 1-3 years’ experience in the field of credentialing in a healthcare environment
- Managed Care Experience
- Minimum of two years profession experience with MS Office Suite- Word, Outlook, Excel, Access
- High School Diploma or equivalent, some college a plus
- Excellent written and verbal communication skills
- Strong organizational skills and accurate work results
- Ability to meet scheduled deadlines with minimal supervision.
- Proficient in Microsoft Office, knowledge of other systems preferred
- Ability to multi-task and deal with complexity on a frequent basis
- Flexible, team player
- Knowledge of Medicare Application processing
Essential Physical Functions:
The physical demands described 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 functions.
- While performing the duties of this job, the employee is regularly required to talk or hear.
- The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
- The employee frequently lifts and/or moves up to 10 pounds.
- Specific vision abilities required by this job include close vision and the ability to adjust focus.
Location City: Orange
Location State: California
Community / Marketing Title: Credentialing Coordinator
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.
We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.
EEO Employer Verbiage:
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact email@example.com.