AmeriHealth Caritas Coordinator Credentialing in Doral, Florida

Coordinator Credentialing


Description

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Credentialing Coordinator is responsible for processing and completing the credentialing and recredentialing functions of all providers in accordance with NCQA, state, and federal requirements.

Principal Accountabilities:

  • Validates completeness of provider applications prior to processing.
  • Conducts primary source verification for all credentialing and recredentialing applications.
  • Monitors the progress and completion of all site visits by the provider network team to ensure completion within established timeframe.
  • Accurately enters all critical data elements of provider applications into Credentialing system.
  • Responds to phone inquiries received into the Credentialing phone queue from internal and external clients.
  • Completes projects as assigned.

Education/Experience:

  • High school Diploma or Equivalency required.
  • Associate Degree preferred.
  • 1-4 years of prior provider credentialing experience based on a combination of education and experience preferred.
  • Intermediate knowledge of PC applications, including Microsoft Office.
  • Strong verbal and written communication skills.
  • Strong organizational skills required.
  • Ability to perform in a metrics-driven environment.