BusinessOperations - Credentialing Specialist 1 - 111453

Position Purpose: Perform credentialing and related activities based on plan specifications

Education/Experience: 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.


" 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

EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

============

n: Position Purpose: Perform credentialing and related activities based on plan specifications Education/Experience: 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. " 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
Story Behind the Need
What is the purpose of this team? Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?		We need these positions to help with daily inventory. Our production is high, and we need assistance to get production down as soon as possible. I do not have any additional upcoming hiring needs, this team member went to another department and would like to come back to cred. We currently do not have any open FTE positions, team member is ok with starting back in temp position.
Typical Day in the Role
Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?		Triage daily inventory and submit to End to End to end, Possibility of moving to End to end, if moved to end they will complete triaged files and submit for approval. We have bi-weekly team meetings, we have group chats set up for different levels of trainings and for the team. Our work environment is very fast paced.
Candidate Requirements
Education/Certification	Required: High School Diploma/GED			Preferred:
Licensure	Required: none			Preferred:
Years of experience required: 1.5 in credentialing, MS Office especially Excel- intermediate level. High proficiency in reading and understanding complex material Disqualifiers: Additional qualities to look for: ability to self-motivate and follow directions
Top 3 must-have hard skills stack-ranked by importance		1	Credentialing
		2	Intermediate Excel knowledge
		3	Reading and comprehension
Candidate Review & Selection
Shortlisting process Candidate review & selection Interview information Onboard process and expectations		Projected Manager Candidate Review Date:			1-2 days post shortlisting
		Type of Interviews:			Teams with Cameras on
		Required Testing or Assessment (by Vendor):			Typing test, basic computers skills test- accuracy over speed when it comes to typing
Next Steps
Do you have any upcoming PTO?
Colleagues to cc/delegate		Barbara Stanley