Credentialing Compliance Auditor - Healthcare Data

COOPER PEDIATRICS; Camden (NJ); On-site; USD 75,000 - 105,000; Full time

Job summary

Cooper University Health Care in New Jersey seeks a Compliance Analyst to support provider enrollment credentialing by auditing files and ensuring compliance with NCQA and The Joint Commission standards.

The analyst will audit 100% of credentialing and recredentialing submissions, verify data in the credentialing database for completeness and accuracy, and serve as a subject matter expert and coach for Credentialing Analysts. Proficiency with Excel and Word is required.

Qualifications

• Computer spreadsheet, database, and audit software literacy.
• Analytical skills, ability to define problems, collect data, establish facts, and draw valid conclusions.
• Strong written and verbal communication. Proficiency in application of audit theory, standards, procedures and techniques.
• Ability to interpret and apply department policies and procedures.

Responsibilities

• Audit 100% of credentialing and recredentialing files to ensure compliance with NCQA, The Joint Commission and other regulatory standards.
• Audit data entered in the Credentialing database for completeness, accuracy, consistency, and gaps.
• Perform follow-up activities related to audit errors to ensure corrections are made; serve as SME and coach for Credentialing Analysts.

Skills

Spreadsheet literacy

Analytical skills

Strong communication

Audit procedures

Education

High School Diploma

Bachelor's degree preferred

Tools

Microsoft Office

Excel

Word

Audit software

Job description

Cooper University Health Care in New Jersey seeks a Compliance Analyst to support provider enrollment credentialing by auditing files and ensuring compliance with NCQA and The Joint Commission standards.

The analyst will audit 100% of credentialing and recredentialing submissions, verify data in the credentialing database for completeness and accuracy, and serve as a subject matter expert and coach for Credentialing Analysts. Proficiency with Excel and Word is required.