Provider Onboarding and Credentialing Specialist Unum GroupProvider Onboarding and Credentialing SpecialistPortland, ME$36,000–$62,400 / yearli>When requested may assist with Credentialing Delegation Reviews by presenting credentialing files to various Delegated Entities and/or reviewing credentialing files, policies and procedures and other monitoring reports to ensure compliance of various Delegated Entities. Assists Network Management and Support staff with provider data management as it relates to adding new providers in System of Record.
Credentialing Specialist Martin's Point Health Care LLCCredentialing SpecialistPortland, MEResponsible for managing the Ongoing Monitoring process between credentialing cycles-Tasks include but are not limited to, quering state agencies to gather information on providers with sanctions, tracking network providers with sanctions, and if applicable, reviewing cases with the Credentialing Committee chairperson. Begins preparation of incoming initial applications with Network Management Provider Operations Representatives to pass on to CVO, to ensure applicant meets the established internal participation criteria for acceptance.