Senior Credentialing Specialist — Hybrid

The Elevance Health Companies, Inc.; Boght Corners (NY); Hybrid; USD 33,000 - 50,000; Full time

Benefits offered by this job

Comprehensive benefits package

401(k) with company match

Equity stock purchase program

Incentive programs

Job summary

Elevance Health, Inc. is seeking a Credentialing Specialist Senior for a hybrid role in New York. The position requires at least 4 years of credentialing experience and an HS diploma or equivalent; CPCS or CMSC are preferred.

The role involves auditing colleagues, managing credentialing documentation, and addressing complex credentialing and accreditation issues. Alternate locations may be considered if within commuting distance.

Qualifications

• Requires a HS diploma or equivalent and minimum of 4 years credentialing experience.
• CPCS or CMSC credentials preferred.

Responsibilities

• 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.
• Assists in delegation oversight and identifies on-going training needs.
• Assists in developing training materials.

Skills

Credentialing

Auditing

Research

Education

HS diploma or equivalent

Job description

Elevance Health, Inc. is seeking a Credentialing Specialist Senior for a hybrid role in New York. The position requires at least 4 years of credentialing experience and an HS diploma or equivalent; CPCS or CMSC are preferred.

The role involves auditing colleagues, managing credentialing documentation, and addressing complex credentialing and accreditation issues. Alternate locations may be considered if within commuting distance.