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Credentialing Coordinator
The Hughston Clinic

Location: Columbus, Georgia
Work Setting: Hospital, Physician Office
Job Function:
Compliance
Job Type:
Full-Time

Job Description

All applicants must apply online at www.hughston.com to be considered.

Position Goal

Maintaining proper understanding of onboarding, privileging and licensing providers to include the period to complete the credentialing process. Serves as the main contact between clinic, facilities and medical boards on requests and processes.

Position Responsibilities:

Utilize effective organizational skills to track requests and provide effective follow up on outstanding items in a timely manner.
Works directly with credentialing company on credentialing and re-credentialing for physicians with appropriate payors, CAQH and NPPES.
Completes application process for providers to include Mag Mutual, DEA, licensing.
Investigates credentialing and contracting denials and makes appropriate recommendations to correct. Assists with claim denial emails
Assists with onboarding for new provider which includes MD/DOs, NP/PAs,PT/OTs, AUD, etc.
Responsible for credentialing physicians/providers when new locations and /or payors are added.
Responsible for maintaining and working Athena Enrollment worklist, payor enrollment group and provider levels to insure claims drop correctly.
Maintains Athena’s correspondence dashboard for enrollment payor notifications, provider IDs and other enrollment type notifications.
Responsible for pulling AR reports for each entity and working appropriately.
Responsible for the day-to-day follow-ups with the payor enrollment vendor that handles our 215+ licensed providers within all of the Hughston’s entities. This includes enrollments for 50+ various clinics, affiliated hospital and/ or surgery centers.

Must be able to use good professional judgment in assigned duties
The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or protected veteran status. This company is a VEVRAA Federal Contractor.

Required Qualifications

Experience: One-year credentialing experience in large medical clinic/hospital setting or in payor or setting required.

Education:

Required: High school graduate or equivalent required.

Preferred:

Degree in related field preferred.
PESC certification preferred.
Special Qualifications:

Required:

Ability to work independently with minimal supervision.
Requires skill in computer systems and applications.
Outstanding organizational skills
Excellent oral/written communication skills
Have the ability to prioritize work/tasks to meet deadlines despite frequent interruptions.
Ability to work in a team environment.

Instructions for Resume Submission

All applicants must apply at www.hughston.com to be considered.

Apply Online: https://hughston.com/about-us/careers/

Posted: July 30, 2021 at 10:22 AM
Post ID: 62138

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