Credentialing Assistant

Humana; Indiana (PA); Remote; USD 43,000 - 57,000; Full time

Job summary

Join a leading healthcare company as a Credentialing Assistant 3, where you'll be pivotal in credentialing medical providers. This remote role combines administrative expertise and healthcare knowledge, allowing you to make a meaningful impact on healthcare services while enjoying a range of competitive benefits.

Benefits

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Short-term and long-term disability

Life insurance

Qualifications

• 1+ years of administrative, support or data entry experience.
• 1+ years in a metric/production driven environment.
• Healthcare experience preferred.

Responsibilities

• Performs initial and recredentialing via APEX.
• Outreaches to providers to obtain required information.
• Manages time to ensure timely completion of tasks.

Skills

Microsoft Office Programs

Communication

Data Entry

Education

Associate's or Bachelor's Degree in Business, Finance or related field

Job description

Become a part of our caring community and help us put health first

The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

The Credentialing Assistant 3 works in a production driven environment with some outreach to providers via phone. The Credentialing Department reviews and verifies providers’ credentials and qualifications to be in network. The department initially credential providers upon joining the network and then recredentials them every 3 years. We ensure Humana’s policy remains in line with NCQA, URAC, and state requirements to maintain accreditation. As a Credentialing Assistant 3 you will play a large role in initial credentialing and recredentialing of our providers.

Typical Responsibilities, But Not Limited To

• Performs initial credentialing via APEX
• Performs recredentialing via APEX
• Corrects errors as identified by leadership via APEX
• Outreaches to the provider/facility as needed to obtain missing/expired info
• Manages their own time to accomplish all necessary task on time
• Big picture - They will help drive the timely credentialing and recredentialing initiatives needed to maintain Humana’s network
  
  

Required Qualifications

Use your skills to make an impact

• 1+ years of administrative, support, data entry, or related professional experience
• 1+ years’ experience in a metric/production driven environment
• Comprehensive knowledge and proficiency in MicrosoftOffice Programs including Word, Outlook, Excel, PowerPoint and Teams
• Demonstrated ability to articulate ideas effectively in both written and oral forms
• Must meet Humana's Work at Home connectivity requirements listed in additional information
  
  

Preferred Qualifications

• Associate's or Bachelor's Degree in Business, Finance or a related field
• Healthcare experience
• Credentialing, Contract Load, Service Fund, Directories or CIS experience
• Provider Network Operations or National Network Operations Experience
• Familiarity with medical terminology
  
  

Additional Information

Work Hours: Start between 7 am-9 am EST and work M-F, 8-hour days (Candidate must be able to work in the EST zone)

Location: Remote within the states listed within the job posting

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
  
  

Interviewing Technology

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

SSN Information

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [e-mail] with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$43,000 - $56,200 per year

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.