Credentialing Specialist 1
- San Antonio, TX
- $19.50-20.00 per hour
- Contract
- Full-time
- Perform credentialing and related activities based on plan specifications.
- 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.
- Triage practitioner files, data entry, outreach through email and phone.
- Meetings, IM, and emails.
- Skills-Credentialing/Re-Credentialing, Documentation & Reporting & Data Handling.
- High School diploma or GED
- Microsoft Office- Excel and Word
- Data Entry
- Customer Service
- Excel and Word
- 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.