Credentialing Coordinator

Company overview

• Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over.
• Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy.
• Zing Health aims to return the physician and the member to the center of the health care equation.
• Members receive individualized assistance to make their transition to Zing Health as easy as possible.
• Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs and a dedicated care team.
• For more information on Zing Health, visit www.myzinghealth.com [http://www.myzinghealth.com/].

Summary description

Coordinate the process of gathering all credentialing materials. Assist with completion of credentialing new and established health care providers. Maintains and updates provider credentialing database. Ability to build relationships with all levels of personnel within the Zing Health Network organization and external provider networks.

Essential functions

• Assures credentialing files are complete with the necessary documentation
• Review credentialing applications, apply policy and criteria, perform primary source verification, process files and forward completed files to appropriate area for processing
• Monitors and conducts appropriate follow-up regarding supportive credentialing documentation including current licensure, malpractice status and history, board certification, and related functions according to established time frames.
• Review monthly regulatory and disciplinary action reports issued by State licensure bodies and the Office of Inspector General Medicaid and Medicare Sanctions reports.
• Understand credentialing requirements per Zing Health policies, as well as state and federal requirements.
• Audit provider directories.
• Produce regularly scheduled network and ad hoc reports.
• Attend and provide support for Credentialing Committee meetings.