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Credentialing Specialist II
6 days agoWhat's your preference?
Job Description
- Req#: JR-82721
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including medical, dental, and vision plans
- Tuition assistance of $5,250/year and student debt pay down of $10,000
- Paid time off, sick leave, and paid parental and family caregiver leave
- Potential for an annual discretionary bonus based on eligibility
- Supportive work environment focused on diversity and inclusiveness
What to Expect (Job Responsibilities):
- Review, investigate, and process primary source verifications for various healthcare providers
- Ensure compliance with National Committee for Quality Assurance and relevant regulations
- Manage credentialing and re-credentialing processes for a managed care organization
- Collaborate with the Credentialing Supervisor/Manager to streamline operations
- Maintain accurate records and documentation throughout the credentialing process
What is Required (Qualifications):
- Minimum of 2 years of directly related experience in managed care provider credentialing
- High School Diploma or equivalent
- Thorough knowledge of credentialing/re-credentialing principles and regulations
- Experience working with organizations such as a CVO, MCO, HMO, or hospital-based credentialing
- Certification as a Certified Provider Credentialing Specialist (CPCS) is preferred
How to Stand Out (Preferred Qualifications):
- Familiarity with data analysis tools and software, including Excel and Epic
- Experience in accounts receivable and revenue cycle management
- Knowledge of CAQH and MPI processes
- Previous work experience in appeals and onboarding processes
- Understanding of provider not enrolled denials
#HealthcareServices #Credentialing #CareerOpportunity #DiversityAndInclusion #HealthcareJobs
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