Review and Audit Coordinator
Randstad is seeking the ideal candidate to work a contract position with a well-known healthcare company in your area. Please see the details below and apply with your resume.
Positions in this function are responsible for all activities associated with credentialing or re-credentialing physicians and providers. Includes processing provider applications and re-applications including initial mailing, review, and loading into the database tracking
system ensuring high quality standards are maintained. Conducts audits and provides feedback to reduce errors and improve processes and performance. Responsible for the development of credentialing policies and procedures. May oversee primary source verification activities.
1.Receive and review application and supporting documents (e.g., questionnaire; attestation form; insurance document) to determine if required and necessary information is included
2. Determine appropriate teams needed to provide validation of submitted information
3.Refer submitted application and supporting documents to internal teams needed to approve or deny entrance into networks
4.Contact and follow-up as needed with provider and/or request assistance from recruiter team to obtain missing information.
5.Identify potential process improvement needs to provider application processes.
6.Provide input into policy changes or updates and/or respond to corrective action requests. regarding provider application processes and related documents.
7.Educate internal and/or external stakeholders regarding application processes (e.g., DEA guidelines; CDS guidelines).
8.Distribute files to applicable stakeholders (e.g., credentialing coordinators) to verify and/or enter information into appropriate
Working hours: 6:00 AM - 3:00 PM
Must have qualifications/experience:
1. High School Education or equivalent Experience.
2.Demonstrates great depth of knowledge/skills in own function.
3.Sometimes acts as a technical resource to others in own function.
4.Proactively identifies solutions to non-standard requests.
5.Solves moderately complex problems on own.
6.Works with team to solve complex problems.
7.Plans, prioritizes, organizes and completes work to meet established objectives.
8.May coordinate work of other team members.
Shift Start/End Time: 6:30 AM to 3:00 PM
Dress Code: Business Casual
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.