Position Purpose: Perform credentialing and related activities based on plan specifications Education/Experience: Associate's degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment. • Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards • Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information • Gather information for Credentialing Committee meetings • Process, track and file credentialing applications within established standards • Generate and utilize reporting to support business functions • Ability to thrive in a fast-paced production environment while maintaining quality Day in the Role Triage daily inventory and submit to End to End to end, Possibility of moving to End to end, if moved to end they will complete triaged files and submit for approval. We have bi-weekly team meetings, we have group chats set up for different levels of trainings and for the team. Our work environment is very fast paced. Must Have: Credentialing Intermediate Excel knowledge Reading and comprehension
salary: $17 - $19 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities
• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
• Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information
• Gather information for Credentialing Committee meetings
• Process, track and file credentialing applications within established standards
• Generate and utilize reporting to support business functions
• Ability to thrive in a fast-paced production environment while maintaining quality
Skills