Privia Health is currently looking for a Credentialing & Enrollment Coordinator to join our rapidly growing team! This person will support all aspects of the credentialing, re-credentialing and privileging processes for all providers in Privia’s high performance medical group.
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Primary Job Duties:
- Data Collection & Management
- Collects provider credentials and updates internal and external databases
- Reviews and streamlines processes and workflows for the on-boarding department, using automation where appropriate
- Assures compliance with all state laws, internal policies and health plan requirements as related to the provider certification and credentialing
- Interacts with varied levels of management, physician office staff and physicians effectively to accomplish credentialing and various elements
- Works with technical staff to develop tools and procedures for auditing and reporting with the goal of streamlining credentialing processes and communicating with company and external stakeholders
- Project Management
- Maintain up-to-date data for each provider in credentialing databases and online systems
- Coordinate and prepare reports
- Record and track credentialing statistics
- Interacts with varied levels of management, physician office staff and physicians effectively to accomplish credentialing and various elements of implementation and launch
- Maintains confidentiality of provider information
Minimum Qualifications:
- 1 to 3 years’ experience in managed care credentialing, billing and/or Medical Staff service setting
- Demonstrated sills in problem solving analysis and resolution
- Attention to detail
- Must be able to function independently, possess demonstrated flexibility in multiple project management
- Must comply with HIPAA rules and regulations
Interpersonal Skills & Attributes:
- High level of attention to detail with exceptional organizational skills
- Ability to problem solve and explore all options and to use available resources to find new and effective solutions
- Team approach to working with others, ability to perform a variety of duties within any work-day and organizational skills from planning to execution of tasks and projects
- Project coordination experience
- Process oriented with the ability to drive a project to completion
- Eager to embrace the challenges and opportunities to build a Credentialing department within a rapidly growing startup environment
- An individual who is passionate about playing a key role in changing the current healthcare environment
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