Credentialing and Managed Care Enrollment Coordinator

Job Description Summary

Manages credentialing and enrollment process with all government and commercial payers

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC001103 SYS - Corp Managed Care

Pay Rate Type

Salary

Pay Grade

Health-26

Scheduled Weekly Hours

40

Work Shift

Job Description

Ensures that appropriate medical staff privileges are received and billing enrollment process is completed for all new providers and locations. 25%

Manages the credentialing and enrollment process with all governmental and commercial payors in a timely fashion on behalf of all MUSC-P and MUHA providers. 25%

Acts as liaison to assist in resolving contract implementation and payment issues with all contracted carriers. 25%

Acts as liaison for patient accounting with managed care payors for all provider enrollment-related claims issues and takes appropriate action to implement solutions to enrollment-related claims issues.

Ensure providers are appropriately categorized for payment purposes with all payors. This process will include completing new provider applications, ensuring that provider credentialing is received and processed timely by the medical staff office, and making credentialing decisions and effective dates. 25%
 

Additional Job Description

Bachelors Degree or equivalent Work Experience: 4-6 of related work experience in medical staff office operations, revenue cycle, and provider enrollment.

Very organized, has high attention to detail, and is able to work independently.  Strong analytical and problem-solving skills.  Strong interpersonal and communication skills (written/verbal).  Knowledge of Excel, Word, and Outlook.  Familiarity with database programs.

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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