Coordinator, Credentialing

About Navista

We believe in the power of community oncology to support patients through their cancer journeys. As an oncology practice alliance comprised of more than 40 sites, Navista provides the support community practices need to fuel their growth – while maintaining their independence.

What Revenue Cycle Management (RCM) contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of a medical practice.

What Managed Care contributes to Cardinal Health

Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other activity as it relates to payer interaction.

The Coordinator, Managed Care, Credentialing is responsible for ensuring an active credentialing/enrollment status with all contracted payors for all groups and providers. This position is also responsible for ensuring that all licensure is updated and active for all groups and providers.

Responsibilities

Responsible for documenting and tracking all credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities within the credentialing platform

Maintain and monitor all licenses and certifications in the credentialing platform to ensure compliance within all regions.

Participate in training sessions and special projects such as learning new system workflows, completing required training, and adopting updated processes within established timeframes.

Coordinate provider enrollment activities (including initial enrollments or re-credentialing) for all groups and providers.

Ensure all facility and provider licenses and certifications are accurate and in good standing at all times.

Complete all forms and supporting documents required to obtain hospital privileges for physicians, as necessary.

Ensure that all processing and reporting deadlines are consistently achieved.

Meet regularly with Credentialing Supervisor and other team members to provide updates on progress and status of credentialing and enrollment matters.

Performs any other functions as required by management.

Qualifications

At least three (3) years of experience of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database preferred

Specific knowledge of the payer environment and payer issues

Ability to work a flexible schedule (including overtime, and weekends), as necessary.

Excellent customer service and communication skills.

Ability to work independently and as part of a team.

Working experience with Excel spreadsheets and Microsoft Word documents.

College degree or commensurate working experience in healthcare preferred

Credentialing database experience (such as IntelliCred, E-Vips, Vistar, Cactus, Symed, etc.) preferred

What is expected of you and others at this level

Applies acquired job skills and company policies and procedures to complete standard tasks

Refers to policies and past practices for guidance

Receives general directions on standard work; receives detailed instruction on new assignments

Consult with supervisor or senior peers on complex and unusual problems

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan