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Managed Care Credentialing Coord

Company: Advocate Christ Medical Center
Location: Downers Grove
Posted on: August 4, 2022

Job Description:

Managed Care Credentialing Coord Job ID: R12885 Shift: 1st Full/Part Time: Full_timeLocation: 3075 Highland Pkwy Downers Grove, IL 60515Benefits Eligible: Yes Hours Per Week: 40Purpose:The Managed Care Enrollment Coordinator is a strategic role within managed care credentialing designed to facilitate the enrollment of Advocate Aurora Medical Group (AAMG) employed and contracted providers through all stages of onboarding in order to enroll them with commercial payers and works as a liaison to AAMG Operations/Contracting departments AAH Payer Activation team and Advocate Physician Partners (APP).Accountabilities:Manages enrollment of all employed and contracted AAMG providers by applying subject matter expertise skills based on specific hiring/contractual arrangements to decide appropriate credentialing variables demographics and service line.Participate and/or request meetings with key contacts in AAMG to sort out appropriate credentialing route and enrollment processing of providers hired/contracted under a unique arrangement/contract. Collaborating with multiple departments/areas to streamline the above processes.Adheres to deadlines and scheduled managed care credentialing committees by tracking files through all stages. Day-to-day responsibility for maintaining proactive communication with internal and external individuals regarding credentialing enrollment and government payor activation processes.Oversee receipt/review and processing of all practitioner demographic/specialty/other changes and resignation requests to be delivered to APP Network Management team for processing and distribution to commercial payers.Communicate regularly via phone fax or written correspondence with Credentials Verification Office Hospital medical staff offices contract entities physicians and group practice offices. Provide direct support to Managed CareCredentialing coordinators in the processing of verifications and database maintenance of credentialing elements for new applicants and reapplicants. Also in tracking timely submission of recredentialing applications from AAMGData entry and record keeping of ancillary practitioners employed by AAMG. Track e

Keywords: Advocate Christ Medical Center, Downers Grove , Managed Care Credentialing Coord, Other , Downers Grove, Illinois

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