Human Resources Manager
Pacific Health Group
Practice Operations Coordinator
Belle
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Junior
About the role
- Prepare and maintain provider enrollment applications (CAQH, PECOS, Medicaid portals, commercial payers).
- Track credentialing and re-credentialing timelines, ensuring timely renewals.
- Maintain accurate provider files and credentialing databases.
- Support contracting submissions and documentation for Medicare Advantage and commercial payers.
- Track contract status, effective dates, and reimbursement schedules.
- Coordinate with Practice Manager on payer inquiries and escalations.
- Verify patient eligibility and benefits prior to appointments and assist with documentation of member responsibility and coverage rules.
- Troubleshoot eligibility issues with payers and escalate as needed.
- Maintain trackers, dashboards, and reports for credentialing, contracting, and eligibility.
- Support compliance and quality programs and assist with general administrative functions of practice management as assigned.
Requirements
- 1–3 years of payer contracting required.
- 1–3 years of experience in healthcare administration, practice management, or a related field.
- Strong organizational skills with ability to manage multiple priorities.
- High attention to detail and accuracy in data entry and document handling.
- Familiarity with healthcare payers, Medicare/Medicaid, and credentialing systems preferred.
- Proficiency in Microsoft Office, Google Workspace, and comfort with EHR/practice management software.
- Strong written and verbal communication skills.
- Self-starter who thrives in a fast-paced, mission-driven environment.
- Must be authorized to work in the United States; employer participates in E-Verify.
