Remote Credentialing Specialist I – Healthcare Operations

Centene Corporation; Nevada; Remote; USD 27,000 - 45,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Remote work options (remote, hybrid,,?

Job summary

Centene is seeking a Credentialing Specialist to perform credentialing and re-credentialing in line with NCQA standards. This fully remote role is open to candidates nationwide, with opportunities to liaise with physicians, office managers, providers, and other third parties to gather needed information.

You will gather materials for Credentialing Committee meetings, process and track applications, and generate reports to support business functions.

Qualifications

• Associate degree or high school diploma/equivalent with 1+ years in data entry, customer service, medical office, provider data management, credentialing or healthcare operations.
• Experience in a managed care or insurance environment is preferred.
• PSV for education verification is strongly preferred.

Responsibilities

• Perform credentialing and re-credentialing according to plan specifications and NCQA standards.
• Communicate professionally with physicians, office managers, providers and third parties to secure needed information.
• Gather information for Credentialing Committee meetings.
• Process, track and file credentialing applications within established standards.
• Generate and utilize reporting to support business functions.
• Thrive in a fast-paced production environment while maintaining quality.
• Perform PSV for education verification.

Skills

Data entry

Customer service

Provider data management

Credentialing

Healthcare operations

Education

Associate degree / high school diploma

Job description

Centene is seeking a Credentialing Specialist to perform credentialing and re-credentialing in line with NCQA standards. This fully remote role is open to candidates nationwide, with opportunities to liaise with physicians, office managers, providers, and other third parties to gather needed information.

You will gather materials for Credentialing Committee meetings, process and track applications, and generate reports to support business functions.