Mountain Park Health Center · 3 days ago
Revenue Cycle Credentialing Analyst
Phoenix, AZ
Full-time
Onsite
Entry, Mid Level
2+ years expMountain Park Health Center is seeking a Credentialing Analyst who will be responsible for analysis, evaluation, and validation of provider information against business and credentialing requirements. The role involves maintaining credentialing databases, ensuring timely credentialing of providers, and coordinating with various plans to meet revenue cycle metrics.
Non ProfitWellnessHealthcareFitnessHealth Care
Responsibilities
Assists with developing metrics that will eliminate and/or reduce timely filling issues due to late credentialing of Mountain Park Health Center providers
Maintains an accurate database containing credentialing status by Provider and Plan
Coordinates with Plans maintaining accurate provider rosters by Plan
Completes provider credentialing and re-credentialing applications and submit credentialing packets to plans before providers start work
Obtains Arizona Health Care Cost Containment System (AHCCCS) and Medicare numbers for providers before providers start providing patient care
Holds plans accountable to credentialing new providers within rules and timeframes established for Federally Qualified Health Centers (FQHC’s)
Partners with billing to resolve credentialing and billing issues
Maintains knowledge of Medicaid, Medicare, private health plans, and agency requirements for credentialing Providers
Sets up and maintains provider information for Council for Affordable Quality Healthcare (CAQH) databases and system
Ensures practice addresses and other key information are current with health plans, agencies, and other entities
Maintains Plan information by provider in credentialing database and uses system of alerts to proactively monitor credentialing deadlines
Creates system to track and respond to communication from Plans and credentialing requests in a timely fashion
Coordinates with Privileging and Human Resources (HR) to ensure initial credentialing forms are returned timely and accurately by new Providers
Performs other duties as required
Qualification
Required
Bachelor's degree and two years of credentialing experience or four years of credentialing experience if applicant does not possess a bachelor's degree
Preferred
Certified Provider Credentialing Specialist (CPCS)
Company
Mountain Park Health Center
Mountain Park Health Center is a non-profit health center that provides healthcare services to the whole family.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Exact Sciences
2022-09-22Grant
Leadership Team
John Swagert
CEO
Recent News
2023-12-25
2023-12-25
2023-12-25
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