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Credentialing Specialist 1 - 111453

Austin, TX 78741

Category: Other Area(s) Job Number: 43780 Location Requirements: Remote

Job Description

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

Education/Experience:
Associate 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

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Amit Singh

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