Workaholics4Hire.com

Location: Work At Home

[COMPANY NAME] is the nations leading health benefits insurer and a Fortune Top 50 company. At [COMPANY NAME], we are dedicated to improving the lives of the people we serve and the health of our communities. [COMPANY NAME] strives to simplify the connection between health, care, and value for our customers.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

Location: Work At Home in any U.S. location preferably Andover, MA.

The Credentialing Specialist Sr is responsible for ensuring the integrity of credentialing data and providing expertise and guidance to other credentialing associates. Primary duties include, but are not limited to:

• Audits work of other credentialing associates.
• Interacts with practitioners and ACSI clients.
• Compiles and reviews documentation required by credentialing committee. Responds to the most complex provider credentialing, compliance and accreditation issues.
• Researches pended and probated applications and resolves discrepancies. Monitors reports identifying practitioners on sanctions or those who do not meet credentialing criteria for further action and assists in researching related issues.
• May assist in delegation oversight and identifies on-going training needs.
• Assists in developing training materials.

Qualifications

Requires a high school diploma, 4-5 years credentialing experience knowledge of NCQA, JC (Joint Commission) and/or URAC credentialing criteria, excellent computer skills, including word processing, spreadsheet and database management software, strong oral and written communication and research/problem solving skills, or any combination of education and experience, which would provide an equivalent background. CPCS or CPMSM preferred.

How To Apply For This Work At Home Job

For full contact details, click this link to visit the site where this ad originally appeared: /careersatwellpoint.com/

If the ad is no longer available, or the position has been filled, please submit your comment below so we can update this listing accordingly. Please assist your fellow job seekers by helping us keep this database up to date and accurate.