Virtua
Overview
At Virtua Health, we exist for one reason - to better serve you. We are dedicated to connecting you to the care you need in moments that matter. We partner to provide wellness, prevention, experienced specialists, life-changing care, and more, building a healthier community. We serve South Jersey with a Magnet-recognized health system and multiple hospitals, departments, and locations, including affiliatons with Penn Medicine for cancer and neurosciences and with the Children’s Hospital of Philadelphia for pediatrics. Job Information
Location:
Lippincott - 301 Lippincott Drive Remote Type:
On-Site Employment Type:
Employee Employment Classification:
Regular Time Type:
Full time Work Shift:
1st Shift (United States of America) Total Weekly Hours:
40 Additional Locations: Job Information: Job Summary
Coordinates all VMG clinicians\' compliance of information with the CAQH (Council for Affordable Quality Healthcare) and PECOS (Provider Enrollment Chain and Ownership System) databases to ensure accurate clinician information is in the CAQH and PECOS system, such as but not limited to documents, affiliations, hours of operations, and call coverage partners. If data is not accurate, the coordinator will be responsible to update and attest appropriately to ensure timely recredentialing. Collects and analyzes information thoroughly to identify potential quality of items for processing to perform the attestation of the information timely and accurately. Works directly with the payers for verification and updates on provider information on websites. Works closely with the internal credentialing services for payer credentialing. Responsibilities
Coordinate with over 550 VMG clinicians to update and maintain PECOS and CAQH to ensure data accuracy for payer credentialing and recredentialing. Coordinate attestation of information in the CAQH system with clinicians and practice managers every 90 days. Maintain all data in the CAQH/PECOS system and ADA compliance for payer requests. Maintain and update the 855B roster of all practice locations for Medicare and Medicaid to obtain payer recredentialing for 550+ clinicians. Manage the Payer Credentialing documents folder and facilitate document gathering for timely CAQH processing. Coordinate quarterly payer audits to ensure accurate roster information in payer directories; act as VMG\'s contact for payer communications. Set up PECOS and CAQH accounts for VMG clinicians and establish clinician NPIs. Participate in department projects and assist team members as required. Required Experience
2-3 years progressively responsible experience in payer credentialing and/or physician billing. Knowledge of payer credentialing guidelines; experience using CAQH, NPI, and PECOS websites. Excellent verbal and written communication and organizational skills. Ability to work independently with attention to detail and accuracy; able to work under pressure for a demanding clientele (physicians). Excellent customer service and flexibility to support team needs. Required Education
High School graduate. Associates Degree preferred. Training / Certification / Licensures
National Committee for Quality Assurance (NCQA) Certification preferred. Hourly Rate: $26.22 - $40.65. The actual salary/rate will vary based on experience and market data. Virtua offers a comprehensive benefits package for full-time and part-time colleagues, including medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, life insurance and other coverages; tuition assistance; and an employee assistance program. Eligibility for benefits is governed by plan documents and policies. For more benefits information click here.
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At Virtua Health, we exist for one reason - to better serve you. We are dedicated to connecting you to the care you need in moments that matter. We partner to provide wellness, prevention, experienced specialists, life-changing care, and more, building a healthier community. We serve South Jersey with a Magnet-recognized health system and multiple hospitals, departments, and locations, including affiliatons with Penn Medicine for cancer and neurosciences and with the Children’s Hospital of Philadelphia for pediatrics. Job Information
Location:
Lippincott - 301 Lippincott Drive Remote Type:
On-Site Employment Type:
Employee Employment Classification:
Regular Time Type:
Full time Work Shift:
1st Shift (United States of America) Total Weekly Hours:
40 Additional Locations: Job Information: Job Summary
Coordinates all VMG clinicians\' compliance of information with the CAQH (Council for Affordable Quality Healthcare) and PECOS (Provider Enrollment Chain and Ownership System) databases to ensure accurate clinician information is in the CAQH and PECOS system, such as but not limited to documents, affiliations, hours of operations, and call coverage partners. If data is not accurate, the coordinator will be responsible to update and attest appropriately to ensure timely recredentialing. Collects and analyzes information thoroughly to identify potential quality of items for processing to perform the attestation of the information timely and accurately. Works directly with the payers for verification and updates on provider information on websites. Works closely with the internal credentialing services for payer credentialing. Responsibilities
Coordinate with over 550 VMG clinicians to update and maintain PECOS and CAQH to ensure data accuracy for payer credentialing and recredentialing. Coordinate attestation of information in the CAQH system with clinicians and practice managers every 90 days. Maintain all data in the CAQH/PECOS system and ADA compliance for payer requests. Maintain and update the 855B roster of all practice locations for Medicare and Medicaid to obtain payer recredentialing for 550+ clinicians. Manage the Payer Credentialing documents folder and facilitate document gathering for timely CAQH processing. Coordinate quarterly payer audits to ensure accurate roster information in payer directories; act as VMG\'s contact for payer communications. Set up PECOS and CAQH accounts for VMG clinicians and establish clinician NPIs. Participate in department projects and assist team members as required. Required Experience
2-3 years progressively responsible experience in payer credentialing and/or physician billing. Knowledge of payer credentialing guidelines; experience using CAQH, NPI, and PECOS websites. Excellent verbal and written communication and organizational skills. Ability to work independently with attention to detail and accuracy; able to work under pressure for a demanding clientele (physicians). Excellent customer service and flexibility to support team needs. Required Education
High School graduate. Associates Degree preferred. Training / Certification / Licensures
National Committee for Quality Assurance (NCQA) Certification preferred. Hourly Rate: $26.22 - $40.65. The actual salary/rate will vary based on experience and market data. Virtua offers a comprehensive benefits package for full-time and part-time colleagues, including medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, life insurance and other coverages; tuition assistance; and an employee assistance program. Eligibility for benefits is governed by plan documents and policies. For more benefits information click here.
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