Provider Credentialing Specialist

ICONMA, LLC • United States, United States • 21h ago

Our Client, a Health Insurance company, is looking for a Provider Credentialing Specialist for their Detroit, MI / Hybrid location. Responsibilities:

Responsible for the processing of practitioner and organization/facility provider applications for credentialing and recredentialing; requesting primary source documentation, processing documentation requirements, verifying information received, updating information in the system of record, evaluating over all case categorization and reporting findings to the Medical Director and Enterprise Credentialing Committee.

Resolve inquiries related to credentialing file disposition.

Provide credentialing status information for group administrators, physicians and their staff, Provider

Services, Customer Service and Network Development Inquiries.

May bedesignated by the leader to attend Credentials Committee meetings and conduct internal meetings and participate in auditing processes.

Assist with special projects and job aids as needed.

Requirements:

Associate degree preferred.

Two (2) to five (5) years of work experience in provider enrollment, contracting, medical practice or hospital business office role and/or credentialing related field required.

Knowledge of related state/federal regulations, NCQA, DIFS,MDHHS and CMS standards for credentialing required.

Knowledge of CAQH required.

Excellent organizational skills with attention to detail required.

Excellent verbal and written communication skills required.

Ability to handle and prioritize multiple case files and timelines required.

Ability to work effectively independently or in a team environment required.

Intermediate knowledge of Microsoft Word, Excel, Access, PowerPoint, and internet use required.

Why Should You Apply?

Health Benefits

Referral Program

Excellent growth and advancement opportunities

Similar Jobs

Commercial Concrete Foreman

Carrier Mausoleums Construction • Full-time • Houston, Texas, United States • $100k - $120k / year • 3w ago

Trucking & Construction Construction Manager Construction Operations Leadership

The Company... Carrier Mausoleums Construction U.S.A. , Inc. (CMC USA) is a Canadian/American construction company renowned for delivering unique, high-quality projects across North America. For over 40 years, CMC has se...

3w ago

Go to Apply

Debt Collector

MA Bosphorus Construction • Contract • Remote (USA) • $800 - $1k / week • 4w ago

Trucking & Construction Debt collector Personal Assistant account payable

You will need to need to research information about debtors, including finding out details like new addresses and other contact information. Works with coworkers to set debt collection strategies. Leads the debt collecti...

4w ago

Go to Apply

Data Products & Strategy Lead

Humana • Cheyenne, WY • 2h ago

IT & Engineering

Become a part of our caring community The Data Product & Strategy Lead drives enterprise value by developing automation opportunities across CenterWell segments, including Home Health, Primary Care, and Pharmacy. You...

2h ago

Go to Apply

Data Products & Strategy Lead

Humana • Montpelier, VT • 2h ago

IT & Engineering

2h ago

Go to Apply

Data Products & Strategy Lead

Humana • Richmond, VA • 2h ago

IT & Engineering

2h ago

Go to Apply

Data Products & Strategy Lead

Humana • Salem, OR • 2h ago

IT & Engineering

2h ago

Go to Apply

Data Products & Strategy Lead

Humana • Atlanta, GA • 2h ago

IT & Engineering

2h ago

Go to Apply

Data Products & Strategy Lead

Humana • Boise, ID • 2h ago

IT & Engineering

2h ago

Go to Apply

Data Products & Strategy Lead

Humana • Springfield, IL • 2h ago

IT & Engineering

2h ago

Go to Apply

Data Architect

Colgate-Palmolive • Piscataway, NJ • 2h ago

IT & Engineering

Relocation Assistance Offered Within Country Job Number #173743 - Piscataway, New Jersey, United States Who We Are Colgate-Palmolive Company is a global consumer products company operating in over 200 countries specializ...

2h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)