Credentialing & Enrollment Coordinator

Monday-Friday 8:30-5:00-Remote

Remote work is currently only approved for residents living in the following states:  AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.

Pay Range:

Essential Functions

• Processes and submits complete, timely and accurate applications and rosters to the appropriate constituents directly.
• Interprets and assists in implementing the standards of the National Committee for Quality Assurance (NCQA).
• Maintain and audit credentialing software and data integrity and updates database accordingly.
• Processes requests and prepares correspondence to health plans through monthly communications.
• Serves as the first contact when communicating with practices and health plans regarding enrollment issues and directory listings.
• Performs health plan quarterly, semi-annual, and annual audits.
• Maintains current licensure, certifications, malpractice insurance, and any other applicable regulatory items at time of appointment and continuous maintenance going forward to ensure timeliness, accuracy and integrity of the credentialing database system and compliance with the regulatory agencies.

Skills: Must be tech savvy, a self-starter, detail oriented, and have solid critical thinking skills.

Physical Requirements
Performs most work under normal office conditions. Work may require sitting for long periods of time, standing, walking, using repetitive wrist/arm motion frequently and lifting.

Education, Experience and Certifications

High School Diploma or GED required; Bachelor's Degree preferred. Certification by National Association Medical Staff Services or Certified Provider Credentialing Specialists preferred. Previous experience as a Credentialing Coordinator or Provider Enrollment preferred. Knowledge of NCQA standards and guidelines.

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Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.