Welcome to 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 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 to assure compliance with the payer credentialing requirements and delegated carrier agreements and NCQA requirements that are built into our policies and procedures. Work includes responsibility for the coordination of all operational aspects related to delegated credentialing, non-delegated and governmental credentialing, including organizing and assisting programs required for establishing procedures for payer credentialing of physicians / allied health professionals. Complete all required governmental forms for Medicare and Medicaid timely and follow through till completion and assigned numbers and effective dates. Complete tracking tool for credentialing processes and effective dates. Assist with completion and updates of Council for Affordable Quality Healthcare (CAQH) profiles. Up to 25% travel to CHPG practices to gather required credentialing information to support the NCQA, CMS and URAC requirements. Build relationships with commercial and governmental carriers to follow-up on outstanding items, through obtaining assigned effective dates or confirmation of correct provider load. Assist in pulling required reporting from CACTUS software, and follow-up with physicians/allied health professionals to assure accuracy and timeliness of information submitted to carriers. Assist with ongoing improvements and development of CHPG delegated credentialing policy and procedures. Understand and engage in National Committee for Quality Assurance (NCQA) requirements, to effectively work with our delegated commercial carriers. Work is reviewed by the Supervisor of the department through reports, conferences and adherence to 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:
1-3 years of healthcare-related physician/allied health professionals credentialing experience, business office experience or billing experience required.
Must have strong organizational, written, verbal, problem solving, and relationship building skills.
Ability to work independently and multi-task CACTUS software expert preferred.
Your Connected Community
Centura Health is headquartered in Centennial, CO, with additional business office locations throughout the Denver Tech Center. The Corporate Service Center is home to our leaders and centralized teams that support our hospitals, clinics and people including marketing, human resources, employee benefits, finance, billing, talent acquisition/development, payor relations, IT, project management, community benefit and more. Whether you work in the corporate headquarters or one of our nearby offices, youll experience a culture of collaboration and community where incredible people are doing incredible things every day.
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.