Credentialing Specialist 1

Immediate need for a talented Credentialing Specialist 1. This is a 04-06+ Months Contract opportunity with long-term potential and is located in Tampa, FL (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-72509

Pay Range: $26 - $28/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities:

• Location-Within 100 miles of Tampa, FL 33631 or 33634, but will be working remotely.
• Perform credentialing and related activities based on plan specifications.
• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards.
• Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information.
• Gather information for Credentialing Committee meetings.
• Process, track and file credentialing applications within established standards.
• Generate and utilize reporting to support business functions.
• Ability to thrive in a fast-paced production environment while maintaining quality.
• The online webform submissions generate an email that is received in a shared mailbox. 
• Each credentialer has a folder with their name on it and the emails are assigned to those folders. 
• We have a team chat for anyone on the team to ask questions. 
• The idea is for the emails assigned to be worked from oldest to newest, they will create a practitioner folder in our S Drive where all the documents will be gathered and saved.
• If they can complete the process, the request is submitted through our internal system and a communication to the provider is sent letting them know the process was completed.
• Missing information is tracked in our SharePoint. 
• During the training/learning process the opportunity for OT will not be available. 
• Once the employee can meet our required metrics of completing 75 requests a week during their 8-hour shift, and is able to work independently, the OT opportunity will be extended. 
• Daily schedule is 8:00 am – 4:30 pm., which can be flexible during the day.

Key Requirements and Technology Experience:

• Skills-Credentialing experience.
• Experience or knowledge of NCQA Standards. 
• Work under pressure.
• Time management.
• Communicational skills.
• Nice to haves: NAMSS Credentialing Certification, knowledge of NCQA Standards.
• Attendance, Quality, Timeliness, meeting Metrics, Adaptability.
• Best vs. average:  Best: Ability to meet our productivity metric without losing sight of quality. 
• Average: Ability to complete the assigned tasks, but might require extra guidance to achieve outcomes.
• Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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