Responsible for taking incoming requests for first, second level and external appeals while ensuring high level of customer service and maximizing productivity. Working with appeals team for multiple lines of business such as Commercial, Exchange and Medicare, ensuring the proper submission of appeals for review by pharmacist and medical directors.
The Credentialing Coordinator will be responsible for timely and accurate credentialing activities, including interactions with insurance companies and keeping accurate records. They will gather information, maintain records, communicate approvals, complete re-credentialing applications, resolve denials, and work with the credentialing team.