BusinessOperations - Credentialing Specialist 1

Position Purpose : Perform credentialing and related activities based on plan specifications

Education / Experience : Associate's degree, or high school diploma / equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment.

• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
• Communicate with professionalism with physicians, office managers, providers, and other 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
• Ability to thrive in a fast-paced production environment while maintaining quality

EEO :

"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority / Gender / Disability / Religion / LGBTQI / Age / Veterans."

Story Behind the Need - Business Group & Key Projects

We need these positions to help with daily inventory. Our production is high, and we need assistance to get production down as soon as possible. Typical Day in the Role

Triage daily inventory and submit to End to End to end, Possibility of moving to End to end, if moved to end they will complete triaged files and submit for approval. We have bi-weekly team meetings, we have group chats set up for different levels of trainings and for the team. Our work environment is very fast paced. Compelling Story & Candidate Value Proposition

Our team goes above and beyond and we are always accountable for our production and work load, we do whats right and not was fast. Candidate Requirements Education / Certification Required : i.e. High School diploma, Bachelor's Degree, etc. Preferred : Some college experience or college degree, certificate in credentialing Licensure Required : i.e RN, BSN, LPN, etc. Preferred : none

Must haves :

Some Credentialing experience or provider enrollment experience, Data Entry, Excel

Nice to haves : Disqualifiers :

Unable to work in fast paced environment, unable to be at work when expected. Unable to work from private or secure internet access

Performance indicators :