Credentialing / Enrollment Coordinator

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This role is responsible for initiating, coordinating, monitoring, and maintaining the credentialing, re-credentialing, and licensing process with commercial payors, medical assistance, and licensing boards. In addition, this position will ensure compliance with the accrediting and regulatory agencies, while developing and maintaining working knowledge of the statues and laws relating to credentialing and licensing of clinical staff. This role will support multiple human resources functions including background check screening and employee records. This role is an onsite role based out of our Burnsville, MN location.

Essential Functions

• Responsible for maintaining a positive, professional and pleasant attitude while working with various levels of the organization, and represents Partners in Excellence
• Manages the life cycle of an employee in the medical records system (on-board, updates and completes termination processes)
• Assists staff when necessary
• Scans and saves files to appropriate locations in our database
• Accountable for completing provider credentialing, re-credentialing, and licensing applications for all appropriate clinical staff
• Maintains copies of current state licenses and degrees for contracts and credentialing Tracks license and certification expirations for clinical staff to ensure timely renewals Owns maintaining an accurate credentialing database, files, and correspondence relevant to ensuring compliance with state and regulatory agencies
• Accountable for maintaining up-to-date knowledge of all appropriate credentialing requirements
• Timely research and resolution for all issues related to obtaining credentialing for clinical staff
• Assists billing in helping find resolutions for credentialing and provider enrollment issues Provides weekly updates to management team regarding status of credentialing applications for clinical staff
• Accountable for up-to-date documentation of credentialing process and ensuring process is compliant with all appropriate credentialing requirements
• Owns understanding provider tools and systems including on-line portals
• Completes the Office of Inspector General (OIG) exclusion data base report monthly
• Provides communication on leave of absences, FMLA, and ADA notices; Gathers required documentation, reviews for completion and submits for approval
• Files and monitors worker compensation claims, alerts administrators of medical information and status to support "return to work" process
• Ability to meet deadlines
• Recruitment support; review resumes, phone screens, tabling events
• Ability to learn and operate multiple systems to support HR functions (HRIS, Kudos, Applicant Tracking, credentialing, etc)
• Responsible for initiating, confirming completion, and ensuring Partners is in compliance with all Net Study background checks. This role will communicate updates to various departments within Partners, troubleshoot any potential issues candidates have, and answer all questions related to Net Study.
• Completes the Office of Inspector General (OIG) exclusion data base report monthly
• Will provide back-up support to recruitment, benefits and credentialing
• Follows established procedures for updating, validating, and correcting employee records or other related HR data (spreadsheets and excel workbooks)
• Will need to travel to other locations and hiring events
• Conduct audits and validate the accuracy of information in systems
• Able to engage, share ideas and work with a team of HR professionals
• Essential to possess good judgment and have excellent problem-solving skills
• Manage many concurrent assignments and be very organized and have great attention to detail to coordinate all aspects of the job in a timely manner to meet the needs of this fast-paced environment
• Hold strict standards for confidentiality and must possess strong professional office skills as this role supports the Human Resources team with multiple assignments.
• Must meet the physical demands listed below
• Complete all other projects / duties as assigned

Qualifications

Required Education and Experience

Preferred Qualifications

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