Credentialing Coordinator, Connecticut

Job Summary

Responsible for coordinating the timely and accurate credentialing and re-credentialing of providers with commercial carriers and assisting with CT Medicaid & Medicare enrollment processes, the full-time Credentialing Coordinator in Connecticut will work remotely to manage applications, resolve claim reimbursement issues, and maintain effective communication with clinical departments and insurance carriers.

Key responsibilities

• Coordinates the review of credentialing applications and monitors data accuracy for timely processing
• Assists with CT Medicaid & Medicare enrollment processes and researches claim denials
• Develops and maintains effective communication with clinical practice managers and insurance carriers for credentialing application processing

Required qualifications

• Eight years of related work experience, including six years in a similar role, or an equivalent combination of education and experience
• Comprehensive knowledge of medical credentialing and provider enrollment processes for commercial insurance and government programs
• Strong grasp of regulatory standards related to managed care and physician organizations
• Proficiency in computer applications such as Word, Access, and Excel
• Ability to maintain confidentiality and prioritize multiple tasks effectively