The role is responsible for obtaining insurance precertification and recertification, acting as a liaison with third-party payers, and communicating clinical information to resolve potential denials. Essential duties involve securing authorizations prior to hospitalization, managing urgent/emergent authorizations, and documenting/resolving clinical denials and appeals.

This role involves administratively coordinating the patient experience by scheduling appointments, documenting interactions, and handling insurance coordination within a fast-paced virtual call center. Responsibilities include acting as the first-line administrative contact, providing concierge-like service, and working closely with clinical staff to manage patient care access.

The specialist is responsible for writing and maintaining coding and billing rules in the practice management system, reviewing and importing daily Urologic and Surgical charges, and managing daily claim filing. Key duties include verifying insurance coverage, ensuring accurate charge entry, generating timely claims, and resolving rejections or denials for Urologic and Surgical treatments.

As a Medical Credentialing Coordinator, you’ll play a vital role in ensuring our providers meet the highest standards of care and compliance. You’ll oversee the full lifecycle of credentialing and re-credentialing, helping us maintain trust with patients, providers, and regul...