Medical Credentialing Specialist in Greenwood, IN at Vaco

Date Posted: 8/28/2019

Job Snapshot

  • Employee Type:
  • Location:
    Greenwood, IN
  • Job Type:
  • Experience:
    At least 3 year(s)
  • Date Posted:
  • Job ID:

Job Description

Vaco has partnered with a healthcare company in the Greenwood area for this exciting Medical Credentialing Specialist position!

Job duties include but are not limited to:
  • Coordinates completion of initial medical staff application process through CVO in coordination with FPN Recruitment & Provider Services, FPN Legal and FPN Practices to maintain a compliant provider credentialing file.
  • Coordinates completion of all medical staff reappointment applications through CVO for FPN/SPI providers, as well as, completion of all affiliated hospital reappointments for specialties as required.
  • Coordinates with provider, practice manager/director the completion of ABO Enrollment forms with supporting documents as applicable for new payor enrollments, add locations, change of locations and terminations as requested. Monitors FRANC ABO report to ensure provider is participating in appropriate payor plans. Problem solve with FPN/SPI Practice locations on ABO issues as relates to Provider and patient claim denials.
  • Maintains provider information in online credentialing database system in coordination with CVO, and ensures timely renewal of Medical License, CSR, DEA, expirables and certifications of insurance (COI) in coordination with the CVO.
    • Creates initial data entry in Cactus or designated credentialing system for FPN Only Providers, Persons of Interest, PRN providers and/or those Providers billing through FPN.
  • Coordinate credentialing and/or privileging for providers in shared divisions whose primary location is in Central IN for FPN, ABO, Working Well and Express Care.
  • Provide coverage for credentialing processing as needed for timely privileging and enrollments, and other credentialing projects as requested.
  • 3+ years of medical credentialing experience
  • Strong computer skills with Microsoft Office Program experience/ Work, Excel and Outlook
  • Cactus - credentialing software or similar program such as IndyStaff, Intellisoft, etc.
  • EPIC experience
  • Staff Exposure - coordinating with manage care plans and doing enrollments