How will this role have an impact?
The Credentialing Coordinator is responsible for ensuring clinicians successfully pass through the Signify Health credentialing process. Credentialing functions include, but are not limited to, assisting clinicians with the completion of their credentialing applications, performing primary source verification's and updating and maintaining MD Staff credentialing database in accordance with internal policies and procedures, client health plan contracts, URAC guidelines and applicable state and federal requirements.
This role will report to our Credentialing Manager.
Logistics: This is a hybrid role. Applicants must reside within commuting distance of our Dallas Headquarters located at 4055 Valley View Ln, Dallas, TX 75244
What will you do?
Queries appropriate organizations and evaluates responses to ensure provider compliance with NCQA standards
Establishes and maintains a system for timely processing of credentialing/re-credentialing files in accordance with NCQA policies.
Maintain up to date credentialing database and ensuring data accuracy.
Review and process credentialing and re-credentialing files.
Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
Maintains professionalism at all times when communicating credentialing and/or background concerns with any clinician
Assembles all verified information and prepares files for presentation to the Credentialing Committee
Assist with ongoing monitoring of contracted clincians.
Reviews all background checks, drug tests and TB screenings and record results.
Utilizes the MD Staff credentialing database, optimizing efficiency, and performs query, report and document generation
Assist with special projects.
Be familiar with accreditation standards.
Verify providers’ requirements for approval to work in specific states and plans.
Provides administrative support to leadership within the department and both internal and external stakeholders.
Actively demonstrates teamwork at all times.
Respond for monthly audits.
Respond to requests from various internal departments.
Responsible for the security and privacy of any and all protected health information that may be accessed during normal work activities.
We are looking for someone with:
3-5 years of successful work experience in a credentialing role/department
NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify.
Intermediate or better skills in MS Office; specifically Excel
The base salary hiring range for this position is $16.50 to $28.00. Compensation offered will be determined by factors such as location, level, job-related knowledge, skills, and experience. Certain roles may be eligible for incentive compensation, equity, and benefits.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. Eligible employees may enroll in a full range of medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also offer education assistance, free development courses, paid time off programs, paid holidays, a CVS store discount, and discount programs with participating partners.
About Us:
Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved.
Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.
To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com
Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.
We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.
