Contracting and Credentialing Coordinator at The Auctus Group
South Africa
<meta><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:19pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><b><strong style="font-size:19pt;white-space:pre-wrap;">About the Role</strong></b></p><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><span style="white-space:pre-wrap;">The Contracts & Credentialing Coordinator is responsible for supporting provider enrollment, credentialing, contracting, and payer-related activities to ensure providers are accurately enrolled, credentialed, and maintained with commercial and government payers. This position works closely with providers, insurance carriers, healthcare facilities, and internal teams to ensure timely completion of all credentialing and contracting processes.</span></p><h3 style="font-family:"Basel Grotesk",Arial,sans-serif;line-height:1.6;font-size:19pt;font-weight:600;letter-spacing:0.25px;margin-top:14px;margin-bottom:4px;padding-left:0px;"><span style="font-size:19pt;white-space:pre-wrap;">Responsibilities</span></h3><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Process and submit provider credentialing and contracting applications with commercial and government payers.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Conduct all required follow-up activities until payer approval or completion is obtained.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">File provider practice change notifications and ensure completion with applicable payers.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Update and maintain provider and facility NPI records.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Enroll providers in Medicare, Medicaid, and commercial insurance networks.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Maintain provider records within CAQH and ensure timely attestations and updates.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Track provider licenses, board certifications, DEA registrations, and expiration dates.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Complete provider and facility recredentialing requests and follow-up activities.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Process requests from payers regarding credentialing updates, new contracts, and provider information.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Research and resolve enrollment discrepancies involving providers and facilities.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Complete and maintain ERA, EFT, EDI, and clearinghouse enrollments.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Manage provider access and maintenance within Availity, Optum, Medicare portals, and other credentialing platforms.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Submit accreditation applications and manage follow-up through approval.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Complete licensing applications and renewals across multiple states when required.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Create and maintain Group NPI (GNPI) and Individual NPI (INPI) records through NPPES.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Submit and track hospital privilege and initial appointment applications.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Submit and track DEA applications and renewals.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Maintain accurate documentation and status tracking for all credentialing and contracting activities.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Serve as a liaison between providers, payers, healthcare facilities, and internal departments.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Support special projects related to provider enrollment, credentialing validation, and network participation.</span></li></ul><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"></p><hr><p></p><h1 style="font-family:"Basel Grotesk",Arial,sans-serif;line-height:1.6;font-size:19pt;font-weight:600;letter-spacing:1px;margin-top:24px;margin-bottom:4px;padding-left:0px;"><span style="font-size:19pt;white-space:pre-wrap;">Qualifications</span></h1><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">1–3 years of experience in Contracting, Credentialing, Provider Enrollment, or related healthcare administration functions.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Working knowledge of provider credentialing and payer enrollment processes.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Strong verbal and written communication skills.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Excellent organizational and time management abilities.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Strong attention to detail and accuracy.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to identify, track, and resolve issues independently.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to work in a fast-paced, deadline-driven environment.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to work effectively in a fully remote environment.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams).</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience working with healthcare providers, payers, and credentialing organizations.</span></li></ul><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"></p><hr><p></p><h1 style="font-family:"Basel Grotesk",Arial,sans-serif;line-height:1.6;font-size:19pt;font-weight:600;letter-spacing:1px;margin-top:24px;margin-bottom:4px;padding-left:0px;"><span style="font-size:19pt;white-space:pre-wrap;">Skills and Abilities</span></h1><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Strong organizational and prioritization skills.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to work independently with minimal supervision.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to manage multiple projects and deadlines simultaneously.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Strong problem-solving and critical-thinking abilities.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Excellent customer service and relationship-building skills.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to communicate professionally with providers, payers, and internal stakeholders.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Proficiency in Microsoft Office Suite, particularly Excel and Outlook.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Knowledge of healthcare credentialing, provider enrollment, and payer contracting processes.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Knowledge of medical terminology and revenue cycle processes is a plus.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience with CAQH, Availity, Medicare, Medicaid, Optum, EnrollHub, or similar systems is preferred.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience with Modio, Pipedrive, and LastPass is a plus.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Contract negotiation and payer contracting experience is a plus.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Bilingual skills are a plus.</span></li></ul><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"></p><hr><p></p><h1 style="font-family:"Basel Grotesk",Arial,sans-serif;line-height:1.6;font-size:19pt;font-weight:600;letter-spacing:1px;margin-top:24px;margin-bottom:4px;padding-left:0px;"><span style="font-size:19pt;white-space:pre-wrap;">Required Experience</span></h1><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">1–3 years of experience in provider credentialing, enrollment, contracting, or healthcare operations.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience processing Medicare, Medicaid, and commercial payer enrollments.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience maintaining CAQH profiles and provider records.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience working with payer portals and insurance carrier systems.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience submitting and tracking provider credentialing and recredentialing applications.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience managing multiple provider records and deadlines simultaneously.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience within a multi-provider healthcare organization preferred.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Plastic Surgery, Dermatology, or specialty medical practice experience is a plus.</span></li></ul><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"></p><hr><p></p><h1 style="font-family:"Basel Grotesk",Arial,sans-serif;line-height:1.6;font-size:19pt;font-weight:600;letter-spacing:1px;margin-top:24px;margin-bottom:4px;padding-left:0px;"><span style="font-size:19pt;white-space:pre-wrap;">Physical Demands</span></h1><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><span style="white-space:pre-wrap;">The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.</span></p><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Regularly required to sit and communicate using a computer and telephone.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Regularly required to use hands and fingers to operate office equipment.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Frequently required to reach with hands and arms.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to view and work on a computer monitor for extended periods.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to maintain focus and accuracy when reviewing detailed documentation.</span></li></ul><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"></p><hr><p></p><h1 style="font-family:"Basel Grotesk",Arial,sans-serif;line-height:1.6;font-size:19pt;font-weight:600;letter-spacing:1px;margin-top:24px;margin-bottom:4px;padding-left:0px;"><span style="font-size:19pt;white-space:pre-wrap;">Work Environment</span></h1><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><span style="white-space:pre-wrap;">This position operates in a fully remote work environment.</span></p><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Standard office equipment is required, including a computer, headset, internet connection, phone system, and related software applications.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Employee must maintain a reliable internet connection and workspace that supports productivity and confidentiality.</span></li></ul><p style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"></p><hr><p></p><h3 style="font-family:"Basel Grotesk",Arial,sans-serif;line-height:1.6;font-size:19pt;font-weight:600;letter-spacing:0.25px;margin-top:14px;margin-bottom:4px;padding-left:0px;"><span style="font-size:19pt;white-space:pre-wrap;">Preferred Candidate Profile</span></h3><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:"Basel Grotesk",Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Strong experience with provider enrollment and credentialing.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Comfortable handling high-volume payer follow-ups.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Highly organized and process-driven.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Able to manage multiple providers and projects simultaneously.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Demonstrates ownership, accountability, and attention to detail.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Strong communicator with providers, insurance carriers, and internal stakeholders.</span></li><li style="font-size:11pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience working in a healthcare revenue cycle or medical billing environment is highly preferred.</span></li></ul>
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