Credentialing Specialist I

Davita Inc.; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is seeking a candidate for a fully remote role focused on credentialing providers according to guidelines. The ideal candidate has a high school diploma and experience in administrative roles, with proficiency in MS Office. This position offers flexible scheduling and entails responsibilities including verifying credentials and managing provider files. Organizational skills and attention to detail are essential.

Qualifications

• 1+ years of experience in an administrative role, office environment, billing or other related experience.
• 1+ years of experience in a healthcare environment is preferred.
• 1+ years of Provider Relations or Credentialing is preferred.

Responsibilities

• Verify provider credentials according to guidelines.
• Prepare provider files for review.
• Ensure accuracy of provider information in credentialing systems.
• Recommend system enhancements and process improvements.
• Respond to provider inquiries related to the credentialing process.
• Perform outreach to obtain completed applications.

Skills

MS Office Suite

Typing skills

Organizational skills

Attention to detail

Outreach phone calls

Education

High school diploma or equivalent

Associates Degree or higher in a related field

Job description

Important things YOU should know?

• Fully remote opportunity

• Schedule: Monday - Friday - 7:30am - 4:00pm CST

• Flex Schedule Potential

What will YOU be doing? Ensures organization meets all necessary requirements in credentialing and re-credentialing medical, dental, therapy, and vision providers according to client and NCQA guidelines.

What will YOU be working on?

• Verify provider credentials according to product and quality guidelines for provider acquisition and re-credentialing.

• Prepare provider files for review.

• Ensure accuracy of provider information in credentialing systems by matching provider entered data with all credentialing documents.

• Recommend system enhancements and process improvements.

• Respond to provider inquiries related to the credentialing process

• Perform outreach to providers to obtain completed credentialing applications.

Additional Responsibilities:

• Assist with administrative duties as assigned.

• Assist in annual NCQA accreditation process.

• Assist with answering credentialing phone line.

• Perform outreach to providers to obtain completed credentialing applications.

What qualifications do YOU need to have to be a GOOD candidate?

• Required Level of Education, Licenses, and/or Certificates

  • High school diploma or equivalent

• Required Level of Experience

  • 1+ years of experience in administrative role, office environment, billing or other related experience.

• Required Knowledge, Skills, and Abilities

  • MS Office Suite such as Word, Excel and Outlook.

  • Demonstrated successful typing skills

  • Ability to remain organized and meet multiple conflicting deadlines

  • Attention to detail

  • Ability to place successful outreach phone calls

What qualifications do YOU need to have to be a GREAT candidate?

• Preferred Level of Education, License, and/or Certificates

  • Associates Degree or higher in a related field

• Preferred Level of Experience

  • 1+ years of experience in a healthcare environment

  • 1+ years of Provider Relations or Credentialing