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Credentialing Specialist II (Remote Opportunity!)

Position Overview

The Credentialing Specialist II performs the credentialing and re-credentialing of provider applications in accordance with the departmental policies and procedures and in compliance with applicable State and Federal laws and regulations, as well as National Committee for Quality Assurance (NCQA) standards.

Primary Duties and Responsibilities

Receives and processes incoming applications and supporting credentials from providers

Performs timely follow-up with providers on all pending applications

Performs the primary source verification according to departmental policies and NCQA standards

Builds and accurately maintains provider information in various systems

Responds to inquiries regarding the status of provider’s application

Qualifications

Knowledge, Skills and Abilities

1-3 years credentialing experience, preferably in a managed care setting, preferred

Associate degree or Certified Provider Credentialing Specialist (CPCS) certified preferred

Knowledge of NCQA standards and payer credentialing standards highly desired

Previous experience working with Council for Affordable Quality Healthcare (CAQH) application highly desired

Knowledge of dental industry preferred

Strong computer, data entry and clerical skills required

Excellent interpersonal, oral and written communication skills required

Critical thinking, detail oriented and strong organizational skills required

Leadership Behaviors

Continuously strives to provide superior products and customer service

Builds collaborative relationships that are mutually respectful

Demonstrates self-awareness and embraces feedback

Habilidades: Processamento de Dados, Excel, Pesquisa, Research Writing, Busca na Web

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Acerca do Empregador:
( 0 comentários ) Atlanta, United States

ID do Projeto: #18924682

5 freelancers estão ofertando em média $33/hora para esse trabalho

hestiadm

Good day! I saw your post and it reminds me of my previous job as a customer service representative handling dental eligibility,benefits, claims and the credentialing of our dental providers. I used to work on that lin Mais

$25 USD / hora
(1 Comentário)
3.1
mamunnagain

Hello Hope you are doing well. I have read your project twice and confidently assure i can complete your task perfectly, without satisfaction. I am available to assist yu remote login and can assu=iest yu 24/7 ( res Mais

$33 USD / hora
(0 Comentários)
0.0
dany94g

Actitud

$41 USD / hora
(0 Comentários)
0.0
apollochaitu

Please explain your requirement so that we can process the request. Need to understand exactly what is the requirement to from the practice Just to identify the re-credentialing dates or doing complete enrollment

$25 USD / hora
(0 Comentários)
0.0
joracab

Project Management Software Information Management Agile methodologies DataScience Bussiness Inteligence DataManagement [login to view URL] linkedin: https:/ Mais

$41 USD / hora
(0 Comentários)
0.0