HealthDrive is seeaking an organized entry-level, full-time Credentialing Coordinator to join our team! This position will be responsible for the credentialing and re-credentialing of all provider types with Medicare, Medicaid, and other third-party payers, managing the process, and maintaining up-to-date credentialing information. Additionally, this position will work on project work in Regulatory Affairs with some minor administrative duties.

We are conveniently located off Route 9 in Framingham, MA, close to routes 90 and 495 in a spacious modern office with a workout center available right in the building!

What's in it for you: PPO Medical, Dental, and Vision Insurance, 401(k) + Company match, Paid Time Off, hybrid schedule opportunity, monthly meal program, Verizon Wireless, Dell, and other employee discounts, profit sharing, and employee referral bonuses.

HealthDrive delivers on-site dentistry, optometry, podiatry, audiology, behavioral health, and primary care services to residents in long-term care, skilled nursing, and assisted living facilities. Each specialty offered by HealthDrive is one that directly impacts the quality of daily life for the deserving residents we serve. HealthDrive connects patients in need of vital healthcare to doctors committed to dignity and excellence.

HealthDrive is a place where everyone can grow and training is provided. Join our diverse team today!

• Maintains high-quality, up-to-date, and accurate credentialing processes for all provider types.
• Assists in the credentialing process by entering/logging/scanning information into Credentialing application for initial, updated, and maintenance processes (license/certification renewals), including verifications.
• Processes and maintains credentialing and re-credentialing in accordance with Joint Commission standards and State and Federal Regulatory regulations.
• Monitors collection of all information received; follows up on missing items and/or incomplete forms, submits follow-up requests for verifications as needed.
• Identifies potential red flags and works in collaboration with provider to document the issue and provider response.
• Advises Supervisor of any questionable information received, and any issues identified during the processes.
• Maintains all credentialing files, ensuring that all correspondence in the credentialing and recredentialing process is accurately filed.
• Enters and maintains provider information and documents in company’s third-party credentialing vendor’s portal.
• Works with and assists company’s third - party credentialing vendor for accurate and timely completion of payer applications, collection of provider signatures, and tracking of payer credentialing until approvals received.
• Assists with credentialing related to new payer contracting.
• Other duties and responsibilities as assigned.

Skills & Specifications

• Outstanding organizational skills and attention to detail.
• Excellent judgment & prioritization skills proactively prioritize needs and effectively manages resources.
• Must have excellent communication skills: verbal, interpersonal, and written. This includes strong spelling and grammar skills and basic mathematical calculations.
• Must have strong ability to self-direct and work independently in a high-volume, deadline-driven role.
• Customer orientation: establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Policies & procedures: articulates knowledge and understanding of organizational policies, procedures, and systems.
• PC Skills: demonstrates proficiency in Microsoft Office (Excel, Access, Word) applications and other as required.
• Ability to maintain confidentiality of privileged information gained.Accuracy and attention to detail are crucial for payroll processing
• Well-organized with ability to adhere to deadlines.
• Excellent communication including verbal, written, and listening skills.
• Basic math skills, as they relate to payroll and for calculation of paid time off.
• Ability to communicate and work within a team setting with a positive attitude and willingness to assist team members.

Education & Qualifications

• High school diploma or equivalent required; Associate degree preferred.
• Credentialing experience strongly preferred.

Work Environment

Office setting. Desk/Computer/General office equipment. The noise level in this work environment is usually light to moderate.

Physical Requirements

• Ability to sit for long periods of time.
• Ability to use office equipment such as computer, phone, fax, and copier.
• Ability to lift up to 10 lbs. occasionally for duties related to office work.