Credentialing Specialist CVS Health · Dallas, TX Posted yesterday

QuickCruit, Inc.; Dallas (TX); Hybrid; USD 23,000 - 39,000; Full time

Job summary

CVS Health in Dallas, TX is seeking a Credentialing Specialist to support clinicians through the Signify Health credentialing process and related documentation.

You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database, ensuring adherence to NCQA and URAC guidelines and applicable state/federal requirements.

Qualifications

• Review and process credentialing and re-credentialing files.
• Establish and maintain a system for timely processing of credentialing files in line with NCQA policies.
• Query appropriate organizations and evaluate responses for provider NCQA compliance.
• Maintain copies of licenses, DEA certificates, malpractice coverage and other credentialing documents.
• Review background checks, drug tests, and TB screenings and record results.

Responsibilities

• Review and process credentialing and re-credentialing files.
• Establish and maintain a system for timely processing of credentialing files in line with NCQA policies.
• Query appropriate organizations and evaluate responses for provider NCQA compliance.
• Maintain copies of licenses, DEA certificates, malpractice coverage and other credentialing documents.
• Review background checks, drug tests, and TB screenings and record the results.
• Assemble verified information and prepare files for Credentialing Committee.
• Verify providers’ requirements for approval to work in specific states and plans.
• Assist with ongoing monitoring of contracted clinicians.
• Use the credentialing database to perform queries, generate reports, and optimize efficiency.

Job description

Credentialing Specialist at CVS Health · QuickCruitJob DetailsFull-time# Credentialing SpecialistCVS Health · Dallas, TXTailor My ResumeStart free. No credit card.### About the JobWe’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.Location: Farmers Branch Office, 4055 Valley View Lane, Dallas, TXWork Arrangement: Hybrid preferred for candidates located within 40 miles of the Dallas-Fort Worth office, with an expectation to work onsite at least once per month. Fully remote consideration is available for candidates outside the local area. Will consider candidates across the US, however work schedule would align to central time zone.Position SummaryThe Credentialing Specialist ensures clinicians successfully pass the Signify Health credentialing process. This role is responsible for assisting clinicians with the completion of their credentialing applications, performing primary source verifications, and maintaining the MD Staff credentialing database. The Specialist must ensure all credentialing functions comply with internal policies, client health plan contracts, URAC guidelines, NCQA standards, and applicable state and federal requirements. This position reports to the Credentialing Supervisor.### Responsibilities* Review and process credentialing and re-credentialing files.* Establish and maintain a system for the timely processing of credentialing files in accordance with NCQA policies.* Query appropriate organizations and evaluate responses to ensure provider compliance with NCQA standards.* Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers.* Review all background checks, drug tests, and TB screenings and record the results.* Assemble all verified information and prepare files for presentation to the Credentialing Committee.* Verify providers’ requirements for approval to work in specific states and plans.* Assist with the ongoing monitoring of contracted clinicians.* Utilize the MD Staff credentialing database to perform queries, generate reports, and optimize efficiency.PostedYesterdayJob TypeFull-timeSalary$17 – $28 USD/hourLocation* Dallas, TX