Credentialing Coordinator

Russell Tobin's client, a leading Italian eyewear company are seeking a Credentialing Coordinator to work in New York, NY

The Credentialing Coordinator serves as one of the main resources to administer the credentialing and re-credentialing activities with the team.

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Employment Type: Contract/ Hybrid

Location: New York, NY

Pay rate: $20-$24/hr, DOE

Responsibilities:

• *Supports the overall provider credentialing and re-credentialing processes while maintaining standard turn-around times
• *Responsible to ensure the credentialing files and re-credentialing files are started on time and continue in the process according to standards.
• *Monitors participating provider network for credentialing/re-credentialing deficiencies and takes necessary action per the policies and procedures.
• *Terminates providers who do not comply with the credentialing standards.
• *Prepares and executes outbound communications related to the credentialing events.
• *Researches discrepancies related to provider information.
• *Supports the preparation of weekly rosters to present providers for committee approvals/denials
• *Supports credentialing audits by pulling files and preparing the files for presentation to external clients.
• *Obtains missing information from various sources including the provider to ensure provider maintains compliance with EyeMed Network
• *Executes reports to review and make necessary updates to provider information and provide status to management
• *Prepare reports of status on credentialing activities

Requirements:

• High School Diploma
• 2-3 years business experience with healthcare provider credentialing
• Proficient in Microsoft Office Products (Word, Excel, Access)
• Ability to work well independently, under pressure and multi-tasking
• Ability to successfully work on multiple projects simultaneously while managing time effectively

Nice to have:

• Associate or bachelor’s Degree
• Knowledge of credentialing/provider industry
• Demonstrates sense of urgency
• Experience with operating systems such as EDW/Business Objects
• 1-3 years’ experience in healthcare with a focus on credentialing operations.
• A clear understanding and ongoing knowledge of changes in the Managed Vision Care industry including credentialing, eligibility checking, claims filing and payment receipt.
• Strong organizational skills, and time management.

Benefits that Russell Tobin offers:

Russell Tobin offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.