Credentialing Compliance Analyst - Hybrid
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About The Position
The Credentialing Compliance Analyst responsibilities include developing, implementing, and facilitating the regulatory and accreditation credentialing investigation process. Identifying and analyzing credentialing processes for high-risk, high-volume and problem prone credentialing processes to mitigate risk and improve provider satisfaction. Developing the scope and audit criteria based on regulatory, accreditation and business requirements. Supporting Credentialing Services by coordinating the use of the credentialing database system generating routine and ad hoc statistical reports, maintaining the quality of credentialing data, and assessing credentialing data collection tools. Reviewing potential credentialing non-compliance/discrimination cases. Developing and completing audits, compliant with legislative/regulatory requirements.
