Welcome to the largest health ecosystem in Colorado and western Kansas. Welcome to living your mission among thousands of people on fire to live theirs too. Welcome to options, possibilities and values that guide exceptional care. Welcome to extremely important industry challenges and opportunities to solve complex problems. Welcome to highly intelligent teams, overflowing community and the wholeness of mind, body and spirit that is Centura Health.
Flourishing Begins Here
You have a purpose, unique talents and NOW is the time to embrace it, live it and put it to work. At Centura Health, we value incredible people with incredible skills â but your commitment to a greater cause is something we value even more.
Responsible for administrative work in directing and coordinating a comprehensive specialized credentialing program toÂ assure compliance with the payer credentialing requirements and delegated carrier agreements and NCQA requirementsÂ that are built into our policies and procedures. Work includes responsibility for the coordination of all operational aspectsÂ related to delegated credentialing, non-delegated and governmental credentialing, including organizing and assistingÂ programs required for establishing procedures for payer credentialing of physicians / allied health professionals. CompleteÂ all required governmental forms for Medicare and Medicaid timely and follow through till completion and assignedÂ numbers and effective dates. Complete tracking tool for credentialing processes and effective dates. Assist with completionÂ and updates of Council for Affordable Quality Healthcare (CAQH) profiles. Up to 25% travel to CHPG practices to gatherÂ required credentialing information to support the NCQA, CMS and URAC requirements. Build relationships with commercialÂ and governmental carriers to follow-up on outstanding items, through obtaining assigned effective dates or confirmation ofÂ correct provider load. Assist in pulling required reporting from CACTUS software, and follow-up with physicians/alliedÂ health professionals to assure accuracy and timeliness of information submitted to carriers. Assist with ongoingÂ improvements and development of CHPG delegated credentialing policy and procedures. Understand and engage inÂ National Committee for Quality Assurance (NCQA) requirements, to effectively work with our delegated commercialÂ carriers. Work is reviewed by the Supervisor of the department through reports, conferences and adherence toÂ management guidelines and regulations.
What You Bring/Job Requirements
In addition to bringing your whole self to the workplace each day, qualified candidates will need the following:
High School Diploma or GED
AA or business courses strongly preferred, (without an Associateâs degree, an additional 1-3 years direct experience working experience of commercial payer credentialing)
1-3 years of healthcare-related physician/allied health professionals credentialing experience, business office experience or billing experience preferred
Must have strong organizational, written, verbal, problem solving, and relationship building skills.
Ability to work independently and multi-task
CACTUS software experience preferred/recommended
Sedentary Work - prolonged periods of sitting and exert/lift up to 10 lbs force occasionally)
Your Connected Community
When people and places align, incredible things happen. Just like the 21,000+ amazing associates who work here, every community within Centura Healthâs connected ecosystem has its own unique history, story and personality.Â
Centura Health Physician Group (CHPG) offers providers a true opportunity to live their calling to care while experiencing the support of a built-in comprehensive network, vast resources, professional growth, trusted leadership, generous benefits and an amazing quality of life with locations that span Colorado and into western Kansas. CHPG is proud to connect providers and consumers through state-of-the-art technology, clinical resources and professional expertise to help people live healthier. Our coordinated services represent a full continuum of care â from preventive and early diagnoses to leading-edge treatment and life-saving critical care. CHPGâs ability to deliver better health care value is the direct result of combining the best clinical tools, shared resources and medical expertise with a patient-centered approach that emphasizes Centura Healthâs mission and commitment to quality, compassion and service.
Find your ideal career at Centura Health! With 16 hospitals, physician clinics, hospice services, home care and senior living communities, Centura Health's vast network of care spans Colorado and Western Kansas so you can experience a balanced lifestyle and enjoy a fulfilling career anywhere you want to work, live and play in Colorado. From the fast pace of a Denver-area Level 1 Trauma Center to a smaller rural or mountain hospital – we proudly offer a more diverse range of work settings and locations than any other health care employer in the state. Centura is an equal opportunity employer.