ESSENTIAL DUTIES AND RESPONSIBILITIES Understands and maintains an in depth knowledge regarding the requirements for credentialing physicians with Wisconsin and Illinois Medicare, Medicaid, Blue Cross and other third pay…
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Entry level
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Clinical Research Coordinator II-Pediatric Neurosurgery
Chicago, Illinois, United States · On-site
$50k–$82k/yr
Entry level$15M raised
Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the larges…
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$20/hr–$33/hr
Full-time
associate degree
Medical Insurance, Dental Insurance, Vision Insurance, Life Insurance, Disability Insurance, FSA/HSA Options
Posted 19d ago
~40 hrs/week
Responsibilities
Manage the credentialing and enrollment process for physicians and other providers with Medicare, Medicaid, and third-party payers. Maintain accurate provider data in the Cactus system to ensure timely billing and compliance with state and federal regulations.
Requirements
Requires a minimum of 5 years of experience in healthcare business support or credentialing, with an associate's degree preferred. Proficiency in patient accounting software and knowledge of Wisconsin and Illinois credentialing regulations is highly desired.
Full job description
ESSENTIAL DUTIES AND RESPONSIBILITIES
Understands and maintains an in depth knowledge regarding the requirements for credentialing physicians with Wisconsin and Illinois Medicare, Medicaid, Blue Cross and other third payers as necessary.
Responsible for implementing and obtaining NPI numbers per provider.
Works closely with the Medical Staff Office, Clinic Directors, Clinic Finance, Information Systems and physician recruiters to obtain necessary information on new physicians to complete the credentialing process, in a timely manner, necessary to get claims paid.
Understands the idiosyncrasies of the government forms, which forms are used and what information is necessary for credentialing physicians, physical therapists, CRNAs (Nurse Anesthetists), Physician Assistants, and residents.
Responsible for investigation or follow-up of claims work que.
Understands facility enrollment as appropriate.
Utilizes a system, such as CACTUS, to house and maintain all credentialing information, to include, but not be limited to: when applications are submitted, when payer numbers were received, and what numbers have been assigned to each individual, by location and payer. Ensures confidentiality and accuracy of all credentialing information.
Utilizes the information in Cactus to ensure the re-credentialing process begins prior to any expiration of current statuses/numbers.
Obtains and maintains information necessary for credentialing Illinois physicians with each Mercy laboratory in Illinois with the Illinois Department of Public Aid. Processes information on a timely basis and monitors expiration dates.
As appropriate, is knowledgeable and completes forms/documents as necessary for obtaining provider numbers for Durable Medical Equipment (DME) by location. Monitors expiration dates and initiates the re-certification process in a timely manner.
Responsible for ensuring that all the data maintained in Cactus is current and that all personal information is kept confidential.
Responsible for communicating payer numbers received to a Patient Accounts Application Analyst to ensure the McKesson Plus system is current with the information necessary for timely billing of claims.
Provides reports as necessary for the Credentialing Committee, Patient Accounts, clinics, etc.
Facilitates communication within Mercy Health System on the credentialing process by being an active participant on the Credentialing Committee.
Develops, maintains, and implements policies and procedures necessary to support the credentialing process.
Responsible for educating partners in the application of the credentialing policies and procedures
EDUCATION AND/OR EXPERIENCE
Associate's degree and 1 year of healthcare credentialing/enrollment experience preferred (healthcare facility, managed care setting, CVO, medical staff office, or enrollment), or a minimum of 5 years of experience in credentialing (preferred), or a minimum of 5 years of experience in a healthcare business support area required. Three years' experience working with Wisconsin and Illinois Medicare and Medicaid credentialing regulations, plus managed care payers preferred.
CERTIFICATION/LICENSURE
N/A OTHER SKILLS AND ABILITIES Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Computer Skills To perform this job successfully, an individual should have knowledge of Patient Accounting software; Spreadsheet software and Word Processing software. CACTUS experience a plus.
Language Skills Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Reasoning Ability Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
LEVEL OF SUPERVISION
N/A
SUPERVISES
May supervise as designated by Director.
PAY RANGE:
$20.72 - $33.15
Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.
Mercyhealth offers competitive pay and a comprehensive benefits package including:
Medical, Dental, Vision
Life & Disability Insurance
FSA/HSA Options
Generous, accruing paid time off
Paid Parental and caregiver leave
Career advancement and educational opportunities
Tuition and certification reimbursement
Certification Reimbursement
Well-being Programs
Employee Discounts
On-Demand Pay
Financial Education
Annual recognition/awards events
Partner appreciation days
Family entertainment/attractions discount
Community service/improvement opportunities
Click here for more details regarding Mercyhealth Careers Benefit Information.
At Mercyhealth, we don’t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.
Mercyhealth has been nationally recognized for our commitment to our people and culture, including:
#1 in the nation on AARP's Best Employers for Workers Over 50
One of Working Mother magazine's 100 Best Companies for Working Mothers
A Top 50 Company and Top 10 Nonprofit for Executive Women
Related keywords
CredentialingProvider EnrollmentMedicareMedicaidBlue CrossNPICactusMcKesson PlusDurable Medical EquipmentHealthcare AdministrationMedical Staff OfficePayer NumbersRe-credentialingIllinois Department of Public AidPatient Accounts
At Mercyhealth, our doctors, nurses and staff are committed to making lives better for our patients and their families. They bring knowledge and innovation to ensure that our patients receive world-class health care, close to home.
As an integrated health system, we provide exceptional, coordinated health care for almost every need. Integration improves access to services, technology and treatments, and leads to better outcomes. To best serve our patients, our integration centers around four core service areas: hospital-based services, clinic-based services, post-acute and retail services (home health, hospice, pharmacies, etc.), and a wholly owned and operated insurance company.
At the heart of our organization are more than 7,000 doctors, nurses, staff and volunteers who live the Mercyhealth mission of providing exceptional health care services with a passion for making lives better. We’re committed to working together to make lives better for our patients and their families.
Our passion drives and inspires us to do our very best, and we continuously look for ways to make each life better with the utmost care and professionalism. This can be as complex as a cutting-edge procedure or as simple as a smile. Nothing is ever too small or taken for granted. Everything matters.
Offices: 8201 E Riverside Blvd, Rockford, Illinois 61114, US · 2400 N Rockton Ave, Rockford, Illinois 61103, US · 1000 Mineral Point Ave, Janesville, Wisconsin 53548, US · Hwy 50 and 67, Lake Geneva, Wisconsin 53147, US · 901 Grant Street, Harvard, Illinois 60033, US
health carehospitalhealthcarenurseand doctorHealth CareNon Profit
Based on 2552 listings with disclosed salaries, most administrative jobs in Illinois pay between $50k–$100k per year. Individual offers vary with seniority, company size, and specialization.
How many Administrative jobs are open in Illinois right now?
There are currently 10,937 open administrative positions in Illinois listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Administrative roles in Illinois?
Companies currently hiring include Northwestern Medicine, Chicago Public Schools, OSF HealthCare, Nevada System of Higher Education, Illinois Department of Children and Family Services, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Administrative jobs in Illinois?
Yes — 1769 of the 10937 open administrative positions offer remote or hybrid work (386 remote, 1383 hybrid).
How do I apply for Administrative jobs in Illinois?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.