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Credentialing Specialist
Contract: New York, New York, US
Salary Range: 21.00 - 23.00 | Per Hour
Job Code: 356822
End Date: 2025-01-11
Job Status: Expired
This Job is no longer accepting applications
Position Details:
Industry Healthcare
Job Title Credentialing Specialist I
Work Location Remote
Duration 6+ Months
Pay Range $21 - $23/hr
Job Description:
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Data entry of provider credentialing applications into System.
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Review daily reports for missing information to update in System.
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Email providers for missing credentialing information or to schedule site visits.
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Review weekly term in process report to compare to QNXT for credentialing updates.
Must Have Skills: Data entry experience
Day to Day Responsibilities:
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Data entry from resources into Salesforce
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Email providers for missing credentialing information
Summary:
Responsible for coordinating all aspects of the credentialing and primary source verification process for practitioners and health delivery organizations according to policy and procedures.
Essential Functions:
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Processing Specialist
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Process initial and recredentialing applications from providers, meeting departmental requirements.
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Complete data entry of applications, reviewing them for errors prior to turning in the provider files for quality review, meeting departmental requirements.
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Process the minimum number of provider applications each month, meeting departmental requirements.
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Recredentialing/Termination Specialist
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Prepare and send out recredentialing groups, meeting departmental requirements.
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Complete 1st, 2nd and 3rd requests for recredentialing packets, meeting departmental requirements.
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Send report to various state plans/departments to identify any providers who haven't returned their recredentialing applications or who are past-due for credentialing, meeting departmental requirements. Ongoing Monitoring/Watch Follow-up Specialist
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Complete follow-up for provider files on watch status, meeting departmental requirements. Ensure that follow-up occurs for the ongoing state license action monitoring reports, meeting departmental requirements.
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Ensure that follow-up occurs for the ongoing Medicare/Medicaid sanctions monitoring reports, meeting departmental requirements. t
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Delegation Specialist
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Maintain the minimum volume of delegated provider entered into CACTUS to ensure expected levels of productivity, meeting departmental requirements.
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Enter data into CACTUS of delegate information should be done within required timeframes, meeting departmental requirements.
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Update delegate information received from delegate groups should be completed within required timeframes, meeting departmental requirements.
Knowledge/Skills/Abilities:
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Ability to multi-task efficiently. Superb written and verbal communication skills. Competence with computers and data entry.
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Knowledge of NCQA, CMS, and credentialing criteria. Ability to professionally adapt to a rapidly changing environment and rule set.
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Excellent verbal and written communication skills
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Ability to abide by policies
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Ability to maintain attendance to support required quality and quantity of work
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Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
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Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
Required Education: High School Diploma or equivalent
Required Experience: 0-2 years of relevant experience
Required Licensure/Certification: Certified Provider Credentialing Specialist (CPCS) or, participation in a CPCS progression program.
Job Requirement
- data entry
- Credentialing
- Customer service
- provider services
Reach Out to a Recruiter
- Recruiter
- Phone
- Srividhya M
- srividhya.m@collabera.com
This Job is no longer accepting applications
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