Credentialing Coordinator

Summary

Join Imagine Pediatrics, a tech-enabled medical group providing 24/7 care for children with special needs, as a Credentialing Coordinator. Partner with a Credentialing Specialist to ensure successful provider enrollment and credentialing. Maintain provider data in the Credentialing Platform, support account generation in various portals, prepare application packets, track credentialing information flow, and convert paper documents to electronic files. Monitor time-limited documents, follow the License Renewal Policy, enter renewals into the platform, and design/leverage department reporting. Stay current on NCQA Delegated Credentialing standards and participate in learning opportunities. This role requires experience in provider data and credentialing management for a multi-specialty practice, exceptional organizational skills, and proficiency with computerized databases. Imagine Pediatrics offers competitive compensation, benefits, and perks.

Requirements

• Commitment to continuous learning and staying up to date on the Credentialing industry
• Experience in Provider data management and Credentialing management for a multi-specialty practice
• Exceptional organizational skills, independent work management skills, and proficiency in working with computerized databases required
• Experience working in a growing start up or fast-paced environment
• H.S. Diploma/GED Equivalent

Responsibilities

• Maintain the provider data in the Credentialing Platform by performing data entry and maintenance
• Support Provider account generation and maintenance in Licensure Board and State Medicaid Enrollment portals
• Prepare application packets on behalf of Providers for enrollment in State Medicaid
• Maintain Provider status and demographic information across all applicable internal platforms and external portals
• Track the flow of Credentialing information from the Credentialing Platform to partner health plans and applicable vendors
• Convert paper documents to electronic files where possible
• Monitor time-limited documents to ensure continuous currency
• Follow departmental License Renewal Policy to ensure proper notification to practitioners of impending expirations and assistance with renewals
• Enter renewals into Credentialing Platform, and file hard copies in Provider profile, as applicable
• Design/leverage department reporting to assist with core functions of the Credentialing Team
• Maintain current knowledge of NCQA Delegated Credentialing standards
• Regularly participate in learning opportunities to keep current in the Credentialing industry
• Perform other position duties as required

Benefits

• Competitive medical, dental, and vision insurance
• Healthcare and Dependent Care FSA; Company-funded HSA
• 401(k) with 4% match, vested 100% from day one
• Employer-paid short and long-term disability
• Life insurance at 1x annual salary
• 20 days PTO + 10 Company Holidays & 2 Floating Holidays
• Paid new parent leave
• Additional benefits to be detailed in offer