Payer Services Credentialing Coordinator
Full Time
Louisville, KY 40222
Posted
Job description
WHAT YOU CAN EXPECT:
Job Summary:
The primary role of the Payer Services Credentialing Coordinator is to complete credentialing and enrollments, as well as re-credentialing requests, with all identified health plans for current and new campuses by gathering necessary information and documents to complete the appropriate forms and submit in a timely manner. This is done in coordination with maintaining Trilogy's Contract Management Database, Start-up Dashboards, campus files and Action Plans, as well as keeping up to date with all enrollment statuses via follow-up timelines, inquiries, etc. and communicating all pertinent information and updates to the necessary departments as soon as possible.
Duties/Responsibilities:
Trilogy Health Services was founded in December 1997 and is an innovative, dynamic senior living company based out of Louisville, KY. We are a Fortune Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work. Trilogy has over 100 locations and continues to grow across IN, OH, MI and KY. We offer an outstanding opportunity for a motivated and focused individual to join our growing company and experience the Trilogy Difference. We care for you while you care for others. #C4U
The Trilogy Advantage
Equal Opportunity Employer
Team Trilogy - It's Where You Belong
LOCATION:Trilogy Health ServicesLouisvilleKentuckyTEXT ONE OF OUR RECRUITERS:John (502) 829-7857
Job Summary:
The primary role of the Payer Services Credentialing Coordinator is to complete credentialing and enrollments, as well as re-credentialing requests, with all identified health plans for current and new campuses by gathering necessary information and documents to complete the appropriate forms and submit in a timely manner. This is done in coordination with maintaining Trilogy's Contract Management Database, Start-up Dashboards, campus files and Action Plans, as well as keeping up to date with all enrollment statuses via follow-up timelines, inquiries, etc. and communicating all pertinent information and updates to the necessary departments as soon as possible.
Duties/Responsibilities:
- Process initial credentialing and re-credentialing applications timely and to completion.
- Maintain New Campus Enrollment/Provider Task checklist in accordance with timelines and follow-up dates.
- Communicate openly and quickly to the Manager of Payer Relations, any issues or updates that hinder or help our campuses and residents.
- Gather information and documents to complete credentialing applications with health plans.
- Maintain campus folders with current expiration dates, agreements, communications, etc.
- Maintain current knowledge of payer credentialing processes, procedures, contact information, timelines, and changes.
- Accurately document and retain supporting documentation according to standard operating procedures.
- Identifying discrepancies in information and conduct follow-ups in a timely manner.
- Assist in maintaining Managed Care agreements in the contract management database.
- Assist with monitoring the terms and reimbursement criteria for each contract.
- Monitor and complete Provider Data Management for each campus quarterly for all related payers with accuracy.
- Ensures all new agreements are added and/or updated into the business office contract matrix.
- Adds and ensures that managed care payer materials are uploaded to MCO dashboard.
- Assists with generating, analyzing and/or validating department reports.
- Assists with documentation requested from internal leaders/departments and external parties.
- Assists Manager of Payer Relations and Director of Payer Relations and Authorization Services on special projects.
- Responsible to act as a positive liaison of Trilogy and Provider Relations when communicating with payer reps, campuses, and other third parties, consistently promoting a positive relationship.
- Minimal travel including overnight stay as necessary.
- Works independently with minimal
- Performs other related duties as assigned.
- Excellent verbal and written communication skills.
- Excellent interpersonal and customer service skills.
- Excellent organizational skills and attention to detail.
- Excellent time management skills with a proven ability to meet deadlines.
- Ability to self-start work without much prompting.
- Ability to function well in a high-paced and at times stressful environment.
- Proficient with Microsoft Office Suite or related software.
- Ability to navigate the internet and utilize third party payer systems.
- Interpersonal and analytical skills; gathering and compiling information and analyzing and adjusting discrepancies.
- Review and analyze report information, while using critical thinking skills to evaluate data for regulatory compliance.
- Organize, prioritize, and track multiple tasks with strong attention to efficiency and detail.
- Work independently, as well as collaboratively, within a team environment.
- Provide a high level of customer service in a calm and professional manner within a high-paced environment.
- Ability to focus for extended periods.
- High School diploma or equivalent. Associate degree preferred or equivalent combination of education, certification, and/or experience.
- Certified Professional Specialist (CPS) certification preferred
- Knowledge of medical credentialing and privileging procedures and standards.
- Minimum of three (3) years healthcare insurance credentialing experience.
Trilogy Health Services was founded in December 1997 and is an innovative, dynamic senior living company based out of Louisville, KY. We are a Fortune Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work. Trilogy has over 100 locations and continues to grow across IN, OH, MI and KY. We offer an outstanding opportunity for a motivated and focused individual to join our growing company and experience the Trilogy Difference. We care for you while you care for others. #C4U
The Trilogy Advantage
- Competitive Salaries & Weekly Pay
- Substantial Paid Tuition to Purdue Global
- Generous Health Insurance Options
- Tuition Reimbursement, Scholarships and Student Loan Repayment
- Employee Celebrations
- And much more!
Equal Opportunity Employer
Team Trilogy - It's Where You Belong
LOCATION:Trilogy Health ServicesLouisvilleKentuckyTEXT ONE OF OUR RECRUITERS:John (502) 829-7857
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