AdventHealth
Credentialing Specialist Managed Care -Remote
PayCompetitive
LocationMaitland/Florida
Employment typeFull-Time
This job is now closed
Job Description
- Req#: 24039066
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Benefits from day one, including mental health resources and career development
- Opportunity for career advancement and professional growth within a supportive environment
- Work remotely Monday through Friday, offering flexibility
- Be part of a community that values wholeness and uplifts others in body, mind, and spirit
- Contribute to a mission-driven organization focused on extending the Healing Ministry of Christ
What to Expect (Job Responsibilities):
- Coordinate, monitor, and maintain the credentialing and re-credentialing process for healthcare providers
- Conduct thorough background investigations and primary source verifications of practitioner applications
- Prepare credentialing files for presentation to the AHS Delegated Credentialing Committee and other related committees
- Process requests for privileges and ensure compliance with outlined criteria
- Respond to inquiries from healthcare organizations and assist with managed care delegated credentialing audits
What is Required (Qualifications):
- Experience with credentialing processes in a healthcare setting
- Knowledge of regulatory bodies such as Joint Commission, NCQA, and CMS
- Strong attention to detail and ability to maintain accurate records
- Proficiency in using credentialing databases, such as MSOW/Apogee
- Excellent communication skills for interfacing with internal and external customers
How to Stand Out (Preferred Qualifications):
- Familiarity with the National Practitioner Database and Health Care Quality Improvement Act
- Previous experience conducting internal file audits related to credentialing
#HealthcareServices #Credentialing #RemoteWork #CareerDevelopment #MissionDriven
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
AdventHealth is a Seventh-day Adventist non-profit health care system headquartered in Altamonte Springs, Florida, that operates facilities in 9 states across the United States.