Senior Credentialing Coordinator

About the role

This position is responsible for providing coaching, operational, and infrastructure support to an operations team responsible for credentialing and recredentialing of practitioners and facilities who are currently contracted or wish to be contracted with the Company. This position will research and consult on standard and escalated practitioner and facility credentialing matters.

Responsibilities

• Aid the team in meeting performance goals through inventory monitoring and reporting.
• Manage high-priority and specialized requests as needed.
• Analyze and report on individual, team, and department data for trends, gaps, and variances from performance standards.
• Maintain compliance with company policies and NCQA standards to maintain accreditation.
• Provide ongoing development and coaching to employees.
• Create and maintain internal training materials and lead training efforts for new team members.
• Lead mentorship, audit, and readiness efforts for new team members and those on a performance improvement plan.
• Assist with operational tasks related to credentialing operations.
• Involvement in projects involving the collection of credentialing applications and system design/re-design related to credentialing operations.
• Test all credentialing operations-related systems.
• Act as a subject matter expert for all credentialing activities and train staff extenders on credentialing methodologies and approaches.
• Use knowledge outside of standard procedures to improve contextual understanding of processes.
• Collaborate, coordinate, and communicate across disciplines and departments while ensuring compliance with HIPAA regulations.
• Exercise discretion and make independent decisions on standard and escalated issues concerning applicability.

Requirements

• High School Diploma or G.E.D.
• Bachelor's degree in a relevant field preferred.
• Minimum 2 years of experience in provider credentialing preferred.
• Experience with team member coaching/mentoring or ability to coach/mentor preferred.
• Excellent communication, leadership, problem-solving, and organizational skills.
• Ability to engage staff at all levels to work toward unified goals and objectives.
• Ability to prioritize work and manage multiple tasks effectively.
• Ability to present and speak publicly.
• Proficiency in using software, hardware, and peripherals related to job responsibilities, including MS Office Suites, Microsoft Word, and Excel.
• Ability to work in a standard office environment for extended periods, including sitting and viewing monitors.

Compensation

The salary range for this position is $23 to $26 per hour. Specific offers take into account a candidate’s education, experience, and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k, and bonus opportunity.

Benefits

We offer competitive compensation and benefits packages, an incentive bonus program, recognition and awards programs, and flexible schedules. Our work environment is friendly and supportive, and we provide a wide range of live and web-based professional development and educational programs. Benefits include medical, dental, and vision coverage with low deductibles and copays, life insurance, short and long-term disability, paid parental leave, 401(k) with match, Employee Stock Purchase Plan, tuition reimbursement, flexible spending accounts, employee assistance programs, sick time benefits, and 10 paid company holidays.

EEO Statement

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability, or protected veteran status.