Credentialing & Contracts Coordinator

Reporting to the Manager of Business Services, Credentialing & Contract Coordination, the Credentialing & Contracts Coordinator will be responsible for assisting with the management of the contract lifecycle and management of the verification, enrollment and recredentialing aspects of the organization and its providers.

EDUCATION AND QUALIFICATIONS:

• Bachelor’s degree in business or business-equivalent experience preferred.


• Minimum of one year contract administration experience, three years preferred.


• Minimum of one year experience in medical administration, healthcare, or credentialing.


• Proficient in Microsoft Office, intermediate proficiency in Excel.


• Highly organized and detail oriented to support the many deadlines and organizational requirements.


• Excellent written and verbal communication skills.


• Ability to function independently and effectively in a self-directed environment.

ESSENTIAL JOB RESPONSIBILITIES:

• Facilitate process coordination for contract administration and intake processes, including quality assurance of contract documentation, accuracy and contract terms.


• Track key dates for contract renewal/expirations, initiates the contract review process and provides monthly reports.


• Maintain organized physical and electronic libraries of information inclusive of the contract database, fee schedules, templates, and forms.


• Prepare, submit and track provider applications for Medicare, Medicaid, and insurance.


• Prepare, submit and track key applications and re-certifications of licenses.


• Update provider information in internal systems/databases, CAQH, Availity, PECOS and NPPES.


• Ensure all documentation supports compliance reviews in alignment with internal process and in accordance with The Joint Commission accreditation requirements.


• Perform regular reviews of contract and provider files for organizational updates, renewals and attention to expirations.


• Acts as liaison between providers, internal staff and external parties.


• Participate in departmental planning, performance and initiatives.


• Assist with internal and external audits, when requested.


• Monitor and troubleshoot daily tasks, issues and events.


• Other projects/assignments, as requested.

SKILLS AND COMPETENCIES:

• Professional communication and customer service skills.


• Exceptional attention to detail, strong organizational skills, proficiency in database management, and knowledge of medical terminology. 


• Ability to meet deadlines and work on projects independently and in collaboration with the Contracts team.


• Comfortable with computers and proficiency in relevant organization software and Microsoft Office including Microsoft Excel.


• Proficient in database management and electronic library management.


• Ability to work in a confidential manner, ensuring information is shared with internal and external individuals in an appropriate manner.

COMPANY STANDARDS:

• Demonstrates courtesy, respect, sound judgment, and professionalism.


• Listens with patience and respect for the other person.


• Takes responsibility for own actions and decisions.


• Demonstrates honesty and integrity in all dealings.


• Maintains a positive attitude and caring spirit.


• Makes effective use of work time to accomplish tasks, keeping person business, breaks and socializing to a minimum.


• Dependable, trustworthy, and demonstrates appropriate attendance pattern.


• Demonstrates concern for the rights, opinions, privacy and confidentiality of others.


• Willingly seeks new assignments, assumes additional duties when necessary, and takes independent action to identify problems.


• Seeks management involvement when necessary.


• Demonstrates prudent use of company resources.


• Practices Gulfside’s Mission Statement, Vision Statement, and Core Philosophy in both words and actions.

PHYSICAL DEMAND:

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


• While performing the duties of this job, the employee may be required to stand, walk, sit, use hands to finger, handle or feel objects/tools/controls, reach with hands/arms, climb stairs, balance, stoop, kneel, crouch or crawl, talk, hear, taste, or smell. This employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required for this position include close vision, distance vision, color vision, depth perception, and the ability to adjust focus.

This job description does not list all of the duties of the job. You may be asked by supervisors or managers to perform other duties. You will be evaluated in part based upon your performance of the tasks listed in this job description.

Gulfside has the right to revise this job description at any time. The job description is not a contract of employment and employee or employer may terminate employment at any time.

NOTE: All Gulfside Healthcare Services positions (except some Thrift Shoppe Positions) require an AHCA Level 2 Fingerprint screening for eligibility through the AHCA Florida Care Provider Background Screening Clearinghouse.  Please refer to this link for more information on this:  https://info.flclearinghouse.com