Credentialing Specialist Senior

Elevance Health, Inc.; Latham (NY); Hybrid; USD 33,000 - 50,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Job summary

Elevance Health is seeking a Credentialing Specialist Senior in New York to ensure the integrity of credentialing data and provide guidance to credentialing associates. This role operates in a hybrid model with in-office days 1-2 per week, and alternate locations may be considered if within commuting distance.

The salary range for this location is $24.15–$36.23 per hour, with comprehensive benefits and a strong focus on compliance and accreditation issues.

Qualifications

• Requires a HS diploma or equivalent and minimum of 4 years credentialing experience; or any combination of education and experience.

Responsibilities

• Audit the work of credentialing associates.
• Compile and review documentation required by credentialing committee.
• Respond to complex provider credentialing, compliance and accreditation issues.
• Research pending and probated applications and resolve discrepancies.
• Monitor reports identifying practitioners on sanctions or those who do not meet credentialing criteria for further action and assist in researching related issues.
• May assist in delegation oversight and identifies on-going training needs.
• Assist in developing training materials.

Skills

Credentialing experience

Education

HS diploma or equivalent

CPCS

CMSC

Job description

Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Credentialing Specialist Senior ensures the integrity of credentialing data and provides expertise and guidance to other credentialing associates.

How You Will Make An Impact

• Audits work of other credentialing associates.
• Compiles and reviews documentation required by credentialing committee.
• Responds to the most complex provider credentialing, compliance and accreditation issues.
• Researches pended and probated applications and resolves discrepancies.
• Monitors reports identifying practitioners on sanctions or those who do not meet credentialing criteria for further action and assists in researching related issues.
• May assist in delegation oversight and identifies on-going training needs.
• Assists in developing training materials.

Minimum Requirements

• Requires a H.S. diploma or equivalent and minimum of 4 years credentialing experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities And Experiences

• Practitioner and facility credentialing experience strongly preferred.
• Strongly preferred CPCS or CMSC.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $24.15 to $36.23.

Location(s): New York.

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.