Job Description
Our Client, a Health Insurance company, is looking for a Provider Credentialing Specialist for their Detroit, MI / Hybrid location.
Responsibilities:
Requirements:
Why Should You Apply?
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
Numbers & Facts
| Location | Detroit, MI |
| Industry | Management Consulting Services |
| Salary | $17.57–$21.22 Per Hour |
| Company Size | 2,000 to 2,499 employees |
| Year Founded | 2000 |
| Website | https://www.iconma.com/ |
Benefits
401K, Employee Referral Program, Life Insurance
About Company
ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.
- Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
- Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
- Founded in 2000
- 2000+ Employees
The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.
Skills
- Accreditation Standardsunmatched
- Auditingunmatched
- Communication Skillsunmatched
- Content Management Systems (CMS)unmatched
- Customer Support/Serviceunmatched
- Detail Orientedunmatched
- Establish Prioritiesunmatched
- Federal Laws and Regulationsunmatched
- Health Insuranceunmatched
- Health Planunmatched
- Hospitalunmatched
- Microsoft Access Databaseunmatched
- Microsoft Excelunmatched
- Microsoft PowerPointunmatched
- Microsoft Wordunmatched
- National Committee for Quality Assurance (NCQA)unmatched
- Organizational Skillsunmatched
- Presentation/Verbal Skillsunmatched
- Provider Contractingunmatched
- Provider Credentialingunmatched
- State Laws and Regulationsunmatched
- Writing Skillsunmatched
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