Credentialing and Health Plan Delegation Coordinator

Vancouver, WA - USA

Monthly Salary: $ 26 - 37

Posted on: 6 hours ago

Vacancies: 1 Vacancy

Job Summary

Location: Vancouver Clinic Vancouver WA

Schedule: Monday Friday 7:00am to 4:00pm

About the Role
Vancouver Clinic is seeking a Credentialing and Health Plan Delegation Coordinator to monitor and maintain the credentialing recredentialing and privileging process for our health care providers. This role ensures compliance with regulatory standards (NCQA CMS The Joint Commission AAAHC) while supporting provider enrollment with hospitals surgery centers and health plans.

Key Responsibilities

Coordinate and track provider credentialing recredentialing and privileging.
Maintain accurate provider data in credentialing databases (MD Staff).
Liaise with hospitals health plans and surgery centers regarding provider updates.
Manage provider enrollment with government and commercial health plans.
Conduct credentialing file audits and support compliance with regulatory requirements.
Assist with audits site reviews and billing issues related to provider enrollment.

Qualifications

High School Diploma or equivalent required; college coursework preferred.
3 years of credentialing experience in a clinic hospital or health plan setting with responsibility for credentialing hospital appointment and privileging private and government health plan enrollment - REQUIRED.
Experience with NCQA and AAAHC guidelines REQUIRED.
Strong organizational communication and customer service skills.
Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred.

Pay Range:

$26.80 - $37.52

The above information is intended to indicate the general nature and level of work required in this position. It is not designed to contain or be interpreted as a comprehensive description of all duties responsibilities and qualifications required of those assigned to this job.

We offer a competitive Total Rewards Program. Eligibility for benefits is dependent on factors such as position type and FTE. Benefit-eligible employees qualify for benefits beginning on the first of the month following one month of employment. Vancouver Clinic offers medical dental vision life insurance AD&D long term disability health savings account flexible spending account employee assistance program and multiple supplemental benefits (voluntary life critical illness accident hospital indemnity identity theft protection legal services etc.). We also offer a 401k retirement plan with employer contributions after your first year of employment. Benefits-eligible employees accrue PTO and Personal Time based on hours worked and State worked totaling 120 hours in the first year for full time staff and 200 hours in the first year for full time supervisors and above increasing in subsequent years. PTO and Personal Time accruals are pro-rated by FTE/hours worked. Non-benefits eligible employees will accrue Personal Time based on hours worked and State worked. Employees will also enjoy up to six paid holidays per year depending on schedule. Contact your recruiter for more information.

Vancouver Clinic is proud to be an Equal Opportunity Employer. Vancouver Clinic does not discriminate on the basis of race color gender disability veteran military status religion age creed national origin gender identity or expression sexual orientation marital status genetic information or any other basis prohibited by local state or federal law.

Vancouver Clinic is an alcohol and drug-free workplace. Offers are contingent on successful completion of background screen and immunization requirements.

Required Experience:

Location: Vancouver Clinic Vancouver WASchedule: Monday Friday 7:00am to 4:00pmAbout the RoleVancouver Clinic is seeking a Credentialing and Health Plan Delegation Coordinator to monitor and maintain the credentialing recredentialing and privileging process for our health care providers. This role...