Credentialing Professional
Louisville, KY Louisville, KY Full-time Full-time 7 days ago 7 days ago 7 days ago The Credentialing Professional 2 obtains and reviews documentation to determine status in a health plan.
The Credentialing Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Responsibilities The Credentialing Professional 2 reviews the applicant's education, training, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence.
Reviews the information and documentation collected, as well as verification that the information is accurate and complete.
Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
Follows established guidelines/procedures.
Requirement Qualifications High School Diploma or a related field or equivalent work experience.
Prior work experience in a compliance or auditing function Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint Strong written and oral communication skills Demonstrated attention to detail and accuracy Proven analytical skills and creative thinker Demonstrated ability to respond effectively as issues arise Self-motivated with an ability to manage multiple priorities and work under pressure to meet deadlines Ability to interact effectively with associates across all levels of the organization Must be passionate about contributing to an organization focused on continuously improving consumer experiences Dental Credentialing experience required and PSV experience (Primary Source Verification) Dental Provider experience is required Outbound phone calls experience MS Excel experience and proficiency is required WAH requirements:
Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role).
A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.
Preferred Qualifications Knowledge of state regulations pertaining to compliance in the insurance industry Minimum 2 - 4 years of healthcare / insurance industry experience Project Management skills Scheduled Weekly Hours 40 Not Specified 0.
Estimated Salary: $20 to $28 per hour based on qualifications.
The Credentialing Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Responsibilities The Credentialing Professional 2 reviews the applicant's education, training, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence.
Reviews the information and documentation collected, as well as verification that the information is accurate and complete.
Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
Follows established guidelines/procedures.
Requirement Qualifications High School Diploma or a related field or equivalent work experience.
Prior work experience in a compliance or auditing function Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint Strong written and oral communication skills Demonstrated attention to detail and accuracy Proven analytical skills and creative thinker Demonstrated ability to respond effectively as issues arise Self-motivated with an ability to manage multiple priorities and work under pressure to meet deadlines Ability to interact effectively with associates across all levels of the organization Must be passionate about contributing to an organization focused on continuously improving consumer experiences Dental Credentialing experience required and PSV experience (Primary Source Verification) Dental Provider experience is required Outbound phone calls experience MS Excel experience and proficiency is required WAH requirements:
Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role).
A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.
Preferred Qualifications Knowledge of state regulations pertaining to compliance in the insurance industry Minimum 2 - 4 years of healthcare / insurance industry experience Project Management skills Scheduled Weekly Hours 40 Not Specified 0.
Estimated Salary: $20 to $28 per hour based on qualifications.
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