Payer Services Credentialing Coordinator

Come make a difference at Trilogy, a leader in senior living. We're looking for a dedicated Payer Services Credentialing Coordinator to join our Home Office Team. Our employees love Trilogy for its stability, meaningful work, and great team! If you're looking to grow your career in a place that cares for and values its employees, Trilogy is where you belong!

The Payer Services Credentialing Coordinator will report directly to the Manager of Payer Relations and is responsible for completing credentialing and enrollments, as well as

re-credentialing requests, with all identified health plans for current and new campuses by gathering necessary information and documents to complete the appropriate forms and submit them in a timely manner.

This is done in coordination with maintaining Trilogy's Contract Management Database, Start-up Dashboards, campus files, and Action Plans, as well as keeping up to date with all enrollment statuses via follow-up timelines, inquiries, and communicating all pertinent information and updates to the necessary departments as soon as possible.

Responsibilities:

• Process initial credentialing and re-credentialing applications timely and to completion.
• Maintain New Campus Enrollment/Provider Task checklist in accordance with timelines and follow-up dates.
• Communicate openly and quickly to the Manager of Payer Relations, any issues or updates that hinder or help our campuses and residents.
• Gather information and documents to complete credentialing applications with health plans.
• Maintain campus folders with current expiration dates, agreements, communications, etc.
• Maintain current knowledge of payer credentialing processes, procedures, contact information, timelines, and changes.
• Accurately document and retain supporting documentation according to standard operating procedures.
• Identifying discrepancies in information and conducting follow-ups in a timely manner.
• Assist in maintaining Managed Care agreements in the contract management database.
• Assist with monitoring the terms and reimbursement criteria for each contract.
• Monitor and complete Provider Data Management for each campus quarterly for all related payers with accuracy.
• Ensures all new agreements are added and/or updated into the business office contract matrix.
• Adds and ensures that managed care payer materials are uploaded to MCO dashboard.
• Assists with generating, analyzing and/or validating department reports.
• Assists with documentation requested from internal leaders/departments and external parties.
• Assists Manager of Payer Relations and Director of Payer Relations and Authorization Services on special projects.
• Responsible to act as a positive liaison of Trilogy and Provider Relations when communicating with payer reps, campuses, and other third parties, consistently promoting a positive relationship.

Qualifications:

• High School diploma or equivalent. Associate degree preferred or equivalent combination of education, certification, and/or experience.
• Certified Professional Specialist (CPS) certification preferred
• Knowledge of medical credentialing and privileging procedures and standards.
• Minimum of three (3) years of healthcare insurance credentialing experience.

• Competitive salaries and weekly pay
• 401(k) Company Match
• Mental Health Support Program
• Student Loan Repayment and Tuition Reimbursement
• Health, vision, dental & life insurance kick in on the first of the month after your start date
• HSA/FSA
• Monthly Birthday Parties
• Team Outings
• And so much more!

You may be thinking, "this is too good to be true" but it's not; with our service standards and core values, you'll find what you have been missing here at Trilogy!

Careers close to home and your heart

Since our founding in 1997, we've been making long-term care better for our residents and more rewarding for our team members. We're a Fortune Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work. If you're looking for a place that embraces you for who you are, helps you achieve your full potential, and makes working hard feel less like hard work, then look no further than Trilogy.

As one of Fortune's Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work, Trilogy is proud to be an equal opportunity employer committed to helping you reach your full potential and to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

FOR THIS TYPE OF EMPLOYMENT STATE LAW REQUIRES A CRIMINAL RECORD CHECK AS A CONDITION OF EMPLOYMENT.