Credentialing Coordinator

The Colorado Coalition for the Homeless seeks a Credentialing Coordinator to assists in the development, planning, implementation, process monitoring, maintaining the database, and ensuring the timeliness of the credentialing/re-credentialing process for all applicable CCH employees and volunteers. This role assures credentialing compliance with accrediting and regulatory agencies while also developing and maintaining a working knowledge of relevant statutes and laws. Coordinator maintains CCH locations, staff providers and volunteer’s payer credentialing enrollments and revalidations and NPI and CAQH Profiles. This position primarily works from a remote location within Colorado residence. Occasional meetings will be required in-person at 2130 Stout St., Denver, Colorado 80205 and reports to the Credentialing and Privileging Manager. 

Coalition Benefits
 

In addition to the unique challenges and extraordinary rewards of our work, eligible Coalition employees enjoy a rich benefits package, including:
 

• Health insurance coverage on the first day of employment: full-time employees contribute only 1% of their earnings for their own health coverage and no more than 4% of their earnings for coverage of eligible dependents. We’re proud to offer same- and opposite-sex domestic partner coverage;
• Dental, vision, and flexible spending/dependent care/public transit accounts;
• Free basic life insurance and long-term disability coverage;
• Dollar-for-dollar retirement plan matching contributions up to 5% of earnings;
• Extensive paid time-off, including 8 holidays, 12 days of sick leave, and three weeks of vacation for new full-time employees in their first full year.

Essential Job Functions

1. Facilitates all aspects of credentialing and privileging for initial appointments, reappointments, and reprivileging of providers and volunteers.
2. Processes initial credentialing and reappointments for all agency health professionals (employees and volunteers) in a timely manner and supports the provider’s onboarding to Committee/Board approval.
3. In coordination with Health Services Committee, applies working knowledge of, and proactively reports changes in, all applicable standards, laws, regulations, and Credentialing and Privileging Policies and Procedures.
4. Validates that all required credentialing elements are accurate and completed in a timely manner.
5. Prepares, processes, and maintains CCH location and staff or volunteer provider enrollments with Medicare, Medicaid, DentaQuest, Denver Health, Colorado Access, Beacon, TriWest, and other third-party payer plans.  
6. Performs complete file reviews for credentialing and enrollment audits.
7. Manages provider expirables to email notices and document updates in electronic files.
8. Maintains CCH locations and provider information updating for payer enrollments and NPI and CAQH profiles.
9. Performs provider locations’ linking for Medicaid, Medicare, and all other payer enrollment or disenrollment functions.
10. Serves as CCH liaison to third-party payer plans for the credentialing and audits of providers through  CAQH Proview.
11. Compiles, prepares, and maintains provider NPIs, CAQH, Licensures, DEAs, and payer approval data for rosters or PIWs.
12. Responsible for preparing reports and collecting provider data for projects and supporting other departments in such requests.
13. Create and manage location/provider/payer Dashboard for internal departments to access.
14. Coordinates provider privileging and enrollment approvals in global email distributions and to Revenue Cycle Department.
15. Performs other duties as assigned.
16. Participates in organizational projects or activities pertaining to Credentialing and privileging with various CCH departments such as Human resources, QA, DATA, IT, and operations, and workforce development, as required; promotes good working relationships with all CCH and RPMC staff.
17. Makes him/herself available by cell phone to assist providers, CCH staff, and the Credentialing and Privileging Committee Members.
18. Maintains for confidentiality of providers’ information, accuracy, and integrity of all databases and reporting.
19. Meet required COVID-19 vaccination(s), as defined by applicable law, regulation, or guidance from the Centers for Medicare and Medicaid Services.    
20. Performs other duties as assigned.   

​​Employee must be able to perform essential job functions with or without reasonable accommodation and without posing a direct threat to safety or health of self or others. To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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Qualifications Summary

1. Two plus years health care credentialing and/or provider enrollment experience.
2. Bachelor’s degree or relevant work experience may substitute for advanced education.
3. Must be a Colorado resident.

WHERE A CANDIDATE IS PLACED IN THE COMPENSATION RANGE DEPENDS ON TOTAL RELEVANT YEARS OF EXPERIENCE

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