VMG Credentialing Coordinator

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At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community.

Location : Lippincott - 301 Lippincott Drive

Remote Type : On-Site

Employment Type : Employee

Employment Classification : Regular

Time Type : Full time

Work Shift : 1st Shift (United States of America)

Total Weekly Hours : 40

Additional Locations :

Job Summary

Coordinates all VMG clinicians' compliance of information with the CAQH (Council for Affordable Quality Healthcare) and PECOS (Provider Enrollment Chain and Ownership System) databases to ensure accurate clinician information is in the CAQH and PECOS system, such as but not limited to documents, affiliations, hours of operations, and call coverage partners. If data is not accurate, the coordinator will be responsible to update and attest appropriately to ensure timely recredentialing. Collects and analyzes information thoroughly to identify potential quality of items for processing to perform the attestation of the information timely and accurately. Works directly with the payers for verification and updates on provider information on websites. Works closely with the internal credentialing services for payer credentialing.

Job Responsibilities

• Coordinate with over 550 VMG clinicians to update and maintain PECOS and CAQH to ensure accuracy of data for payer credentials and recredentialing.
• Coordinate and work directly with clinicians and practice managers for attestation of information in the CAQH system every 90 days.
• Maintain all data in the CAQH / PECOS systems and ensure ADA compliance as requested by payers.
• Maintain and update the 855B roster of all practice locations for Medicare and Medicaid to obtain payer recredentialing for over 550 clinicians.
• Manage the Payer Credentialing documents folder and facilitate the gathering of documents for timely processing into the CAQH system.
• Coordinate quarterly payer audits to ensure accurate roster information in payer directories; serve as VMG's contact for payer communications (phone, email, and faxes).
• Set up PECOS and CAQH accounts for all VMG clinicians and establish clinician NPIs.
• Participate in project-related functions within the department and assist other team members as required.

Required Experience

Required Education

Training / Certification / Licensures

Compensation and Benefits

Hourly Rate : $26.22 - $40.65. The actual salary / rate will vary based on applicant's experience as well as internal equity and alignment with market data.

Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including medical / prescription, dental and vision insurance; flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave, short-term disability and optional long-term disability, life insurance and AD&D, tuition assistance, and an employee assistance program. Eligibility for benefits is governed by the applicable plan documents and policies.

For more benefits information click here.

Job Details

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