Provider Credentialing & Payor Contracting Coordinator

Golden State Dermatology (GSD) is a leading and comprehensive dermatology group with 50+ locations and 130 providers throughout the Bay Area, Sacramento, Central Valley and Los Angeles geographies. Planned expansions underway in Colorado, Utah and Nevada. Services include dermatology, cosmetics, radiation therapy, Mohs surgery for skin cancer, pathology, and plastic surgery. GSD has a mission to deliver the highest quality care alongside a great patient, provider, and staff experience. GSD's corporate headquarters is located in Walnut Creek, CA. GSD is a majority physician owned and led Medical Group.

Credentialing & Payor Contracting Responsibilities:

• Submit all credentialing information to GSD's third-party credentialing partner(s) for all new providers (both recruited and acquired). This entails collecting all required information, actively communicating with providers, providing a high level of customer service and ensuring timely completion of all processes.
• Partner, evaluate and manage outside vendors to resolve, track & escalate any open issues on a daily/weekly basis.
• Manage all expirables (medical license, DEA, COI, etc.) for GSD's provider workforce. Provide clear and prompt communication to providers to ensure updates are complete in advance of deadlines.
• Be a super user and system expert in our credentialing/contracting platforms.
• Partner with leadership team to manage existing and new payer contracts. This includes helping in various way to advance payer contracting (e.g., creating provider rosters, submitting payer applications, obtaining provider signatures, and following-up with payers).
• Develop new strategies for reducing turn around times for credentialing & payor contracting / build and optimize communication streams and reporting
• Manage credentialing tracker and report out weekly on all changes and updates to payor contracting and enrollment on a per provider basis to management team
• Work closely with recruiters, hiring managers, and internal teams to ensure timely communication and progress of new hires in the credentialing pipeline.
• Report and advise VP of Network Development and CEO on a daily/weekly basis on provider launch readiness, financial/operational impacts, policy development and procedures.
• This is a high visibility role working directly with key stakeholders of the organization.

Qualifications:

Bachelor's degree in health care, business administration, information technology, or related field. Strong client/customer service orientation. Excellent communication skills. Demonstrated and proven experience working independently with minimal supervision and proficiency in Google Business Suite and Microsoft Office platforms. Prior credentialing experience, or other experience working with physicians in an administrative capacity a plus.

GSD strongly encourages employees to receive the COVID-19 primary series vaccination.

Golden State Dermatology participates in the E-Verify program. E-Verify is a free, web-based system that allows employers to confirm their employees' eligibility to work in the United States. It does this by comparing information from an employee's Form I-9, Employment Eligibility Verification, to records from the U.S. Department of Homeland Security (DHS) and Social Security Administration (SSA).

Golden State Dermatology is an Equal Opportunity Employer. We are committed to creating an inclusive environment for all employees and applicants for employment and do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.