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Privia Health

Sr. Managed Care Coordinator (Credentialing)

Privia Health, Myrtle Point, Oregon, United States, 97458

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Employer Industry: Healthcare Technology Why consider this job opportunity:

Salary up to $65,000.00

Opportunity for annual bonuses targeted at 15%

Comprehensive benefits package including medical, dental, vision, life, and pet insurance, as well as a 401K and paid time off

Strong potential for career growth and professional development within the organization

Supportive work environment that values diversity and inclusion

Flexibility for remote work with reimbursement for home office expenses

What to Expect (Job Responsibilities)

Lead the preparation and submission of comprehensive provider rosters to Managed Medicare, Medicaid, and commercial payers

Audit internal provider data against database records to ensure accuracy before submission

Manage all payer portal uploads and maintain a detailed log of submission dates and confirmation IDs

Serve as the primary point of contact for health plans to resolve roster discrepancies and paneling delays

Analyze provider enrollment timelines and partner with Revenue Cycle Management to resolve billing issues

What is Required (Qualifications)

Minimum of 5 years in healthcare credentialing, provider enrollment, or managed care analysis

Advanced proficiency in Excel, including VLOOKUPs, pivot tables, and data cleaning for large datasets

Familiarity with credentialing databases for data management and reporting

Deep understanding of CAQH, NPI, Availity, and the provider enrollment lifecycle

Experience in Salesforce case management system preferred

How to Stand Out (Preferred Qualifications)

Certification such as CPMSM, CPCS, or CPES through NAMSS

Experience with CredentialStream for credentialing processes

#HealthcareTechnology #Credentialing #CareerGrowth #RemoteWork #DiversityAndInclusion

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