Credentialing Coordinator
On-siteChicago, Illinois, United States
Job Summary
Coordinate the process of gathering credentialing materials for new and established health care providers while maintaining and updating the provider credentialing database. Review credentialing applications, apply policy criteria, perform primary source verification, and monitor follow-up on licensure, malpractice status, and board certification. Audit provider directories, produce network and ad hoc reports, and attend Credentialing Committee meetings. Ensure all files are complete with necessary documentation while adhering to Zing Health policies and state and federal requirements.
Required Qualifications
- High School Diploma
- Two (2)+ years of previous managed care insurance or physician credentialing experience
- Ability to navigate complex health plan enterprise systems
- Ability to analyze data for identifying trends, and variance from goals
- Ability to comprehend JCAHO standards and state and federal laws related to credentialing
- Ability to work autonomously
- Efficient and concise communication skills
- Attention to detail, organized and have excellent time management capabilities
- Microsoft Suite knowledge
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