Remote Credentialing Specialist - Healthcare Network

HCSC Group; Northern (KY); Hybrid; USD 42,000 - 93,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a Credentialing Coordinator for a remote position. You will credential or recredential providers for network participation and prepare materials for review by the medical director or credentialing committee.

You will monitor provider documentation for ongoing compliance and coordinate with internal teams to meet tight timelines while coaching and mentoring staff through processes.

Qualifications

• High school diploma or GED required.
• 3 years business experience.
• 1 year credentialing or quality audit experience.
• Clear and concise interpersonal, verbal and written communication skills for learning/mentoring.
• Experience with multi-tasking and adhering to tight timelines.
• Proficiency with Windows, Word, Excel, Access and related databases.
• Knowledge of Managed Care products, programs and services.

Responsibilities

• Credentialing or recredentialing providers for network participation.
• Present provider credentials to medical director or credentialing committee.
• Ensure documentation is current at committee determination.
• Monitor providers on an ongoing basis to ensure compliance and quality.

Skills

Interpersonal skills

Verbal communication

Written communication

Coaching & mentoring

Multi-tasking

Analytical thinking

Education

High school diploma or GED

Some college coursework in Business or Medical field

2 years college courses in Business or Medical field

Tools

Windows

Word

Excel

Access

Adobe

PowerPoint

Job description

Health Care Service Corporation (HCSC) is seeking a Credentialing Coordinator for a remote position. You will credential or recredential providers for network participation and prepare materials for review by the medical director or credentialing committee.

You will monitor provider documentation for ongoing compliance and coordinate with internal teams to meet tight timelines while coaching and mentoring staff through processes.