drjobs Credentialing and Enrollment Coordinator

Credentialing and Enrollment Coordinator

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1 Vacancy
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Job Location drjobs

El Monte, CA - USA

Hourly Salary drjobs

$ 24 - 28

Vacancy

1 Vacancy

Job Description

Job Details

Entry
Fulgent 4399 El Monte El Monte CA
Full Time
High School
$24.00 $28.00 Hourly
Biotech

Description

About Us

Inform Diagnostics a Fulgent Genetics Company is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology dermatopathology urologic pathology hematopathology and breast pathology.

Founded in 2011 our parent entity Fulgent Genetics has evolved into a premier fullservice genomic testing company built around a foundational technology platform.

Through our diverse testing menu Fulgent is focused on transforming patient care in oncology anatomic pathology infectious and rare diseases and reproductive health. We believe that by providing a wide range of effective flexible testing options in conjunction with bestinclass service and support we can redefine the way medicine is managed for patients and clinicians alike.

Since integrating with our therapeutic development business Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise we aim to become a fully integrated precision medicine company.

Summary of Position

The Credentialing and Enrollment Coordinator is responsible for performing and maintaining the enrollment and credentialing process for health insurance plans state Medicaid entities and Medicare for all companyowned entities. Included in these activities are the processing of Commercial and Governmental applications and reapplications initial mailing review and loading into the database tracking system ensuring timing and quality standards are maintained. Additionally the Credentialing and Enrollment Coordinator must have the ability to prioritize and organize complex activities/projects and track progress as well as work effectively and collaboratively with others. The ideal candidate will possess contract administration experience including appropriate analytical skills attention to detail and will be able to work independently.

Key Job Elements

  • Securing and maintaining all health insurance plan enrollment and reenrollment for the Company
  • Perform necessary followup with appropriate state and federal agencies
  • Completing commercial plan facility credentialing and recredentialing forms for the Director of Managed Care
  • Securing Electronic Funds Transfer form with appropriate Company authorized signature
  • Create and maintain web portal registration for executed contracts
  • Manage the controlled flow of contract documents through the company to secure appropriate Legal review and Executive signatures
  • Maintain Commercial Contract Summary Log
  • Maintain government entity Tracking log
  • Maintain department files in an organized accurate secure manner.
  • Manage incoming and outgoing departmental mail.
  • Process credentialing applications/enrollments and the supporting documentation.
    • Enroll entities in Medicare and revalidate information as necessary.
    • Enroll entities in State Medicaid programs and revalidate information as necessary.
    • Complete commercial health plan credentialing and recredentialing documents for all entities.
    • Complete credentialing and recredentialing documentations for all entities which require physician credentialing.
  • Track license and certification expirations to confirm renewals.
  • Maintain accurate information for entities updating their credentials as necessary.
  • Perform data entry into databases or systems.
  • Responsible for health plan/government entity providerrelated communications pertaining to credentialing/enrollment.
  • Respond to internal and external customer inquiries regarding credentialing/enrollment status.
  • Perform other duties as required or assigned.

Qualifications

Knowledge/Experience

  • High School diploma or equivalent
    • Bachelors degree preferred
    • 1 years of experience in healthcare contracting
    • Computer skills to include Word Excel Power Point Outlook
    • Strong interpersonal and communication skills both written and oral with varying levels of colleagues and/or management
    • Ability to manage open projects to the end with successful follow up
    • Attention to detail and strong organization skills
    • Ability to work independently within guidelines and company policies
    • Ability to effectively present information and respond to questions from managers clients and customers

Environment

Fulgent Therapeutics LLC is an Equal Employment Opportunity Employer.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. The term qualified individual with a disability means an individual with a disability who with or without reasonable accommodation can perform the essential functions of the position.

For California residents please see the link below to access our CCPA Privacy Notice.

CCPA Privacy Notice for California Residents

https://tinyurl/FulgentCCPA

Please note that Fulgent (and itsaffiliatedcompanies includingInform Diagnostics and CSI Laboratories) does not accept unsolicited information and/or resumes from search firms or agencies for our job postings. Search firms or agencies without an applicable contract and/or express approval to recruit for the role in question thatchoose to submit a resume or client information to our career page or to any employee of Fulgent will not be eligible for payment of any fee(s) and any associatedshareddata will become the property of Fulgent.


Required Experience:

IC

Employment Type

Full-Time

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