Credentialing Specialist I

Centene

251d • $19 - $32

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: 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.

Requirements

• 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 experience.
• Experience preferably in a managed care or insurance environment.

Responsibilities

• 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.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules

What This Job Offers

• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: Associate degree