Credentialing Coordinator OrthoNet
Responsible for assuring that all provider-credentialing services are performed according to OrthoNet policies/workflows and
are in compliance with NCQA guidelines and contracted health plan directives.
? Customer service experience in a healthcare environment.
? Pleasant and professional demeanor. Articulate and excellent communication skills.
? Computer literate, experience with Microsoft office.
? Familiarity with provider credentialing protocols.
? Associate?s Degree preferred or 1 year relevant experience in healthcare environment.
ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDE THE FOLLOWING:
? Maintain a professional relationship with contracted provider offices, inter-departmental employees and managed care
? Serve as administrative liaison under the direction of the Credentialing Supervisor in preparing credentialing files for
? Process provider calls in a clear, professional, and timely manner.
? Develop an understanding of the NCQA credentialing protocols and provide necessary information to customers
contracted with OrthoNet.
? Assist with mailings and projects as necessary.
? Work with team to meet department goals and continuous process improvement initiatives.
? Prepare application packets for prospective providers as needed.
? Assist with credentialing audits as needed and directed by management.
? Understand the general non-clinical terms of all OrthoNet contacts to answer any questions a provider may have
regarding a contract.
? Perform all other duties as assigned
EDUCATION AND/OR EXPERIENCE:
? High School Diploma or GED Required
Knowledge, Skills & Abilities:
? Interpersonal and communication skills
? Proficiency in operating computers applications.
? Excellent interpersonal skills.
? Excellent verbal and written communications skills.
MACHINES, OFFICE EQUIPMENT & SOFTWARE:
? MS Office (MS Word, Excel, and Power Point)
||1311 Mamaroneck Avenue |
White Plains, NY 10605