Credentialing Specialist

NEEDED ASAP FOR 6 MONTH PROJECT

The Credentialing Specialist is responsible for verifying submitted Credentialing documentation for all Ophthalmology and Optometric practitioners who provide services to companies members.

Essential Responsibilities

Ensure compliance with all individual States, the National Committee for Quality Assurance (NCQA), and company regulations and standards, when credentialing or re-credentialing all applications and documentation submitted to company.

Primary source verify all required practitioner credentials, including but not limited to education, training, licenses, and malpractice insurance.

Enter all Primary Source Verification data into is companies proprietary computer program.

Create and maintain provider files in compliance with all company policies.

Assist in preparing all documentation required for presentation to various companies committees as requested.

Education

High School Diploma, GED, or equivalent work experience

Two year college degree preferred.

Experience and Background

One to three (3) years of experience in Managed Care Credentialing preferred

Detail Orientated

Strong customer focus

Proficiency in Data Entry

Proficient in Microsoft Windows, experience with Excel, Outlook and Access applications preferred.

Working knowledge of Microsoft SharePoint.

Must be detail orientated and well organized.

Must be able to communicate clearly and effectively with other associates and clients.

Must be energetic and self-motivated.

Must be a team player.

Must be able to problem solve.

Located Downtown - Must pay for parking

https://jobboard.tempworks.com/OpTechGente/Jobs/Details/122672