Credentialing Specialist

Andros

35d•$24

About The Position

The mission of this role is to help coordinate and manage our Facilities and Provider credentialing within our Network Management team, its processes, and services. Support a seamless client experience and deliver on all client SLAs - at all times. Provide transparency, communication, and documentation of credentialing processes, workflows, and other artifacts that can be shared internally and with clients. Adhere to, support, and drive quality measures for the overall credentialing operation, both within Andros and client-facing operations, ensuring excellence in service delivery, program health, and compliance adherence.

Requirements

Familiar with provider credentialing and recredentialing requirements
Strong computer and software skills
Excellent interpersonal skills, including excellent verbal and written communication skills
Ability to demonstrate a high degree of trust and confidentiality
Ability to work independently and assume assigned responsibilities
Skilled in efficiency, organization, time management, and prioritization
Ability to be flexible and function well in a fast-paced environment
Ability to deal with problems involving several concrete variables in standardized situations
Ability to handle confidential information
Minimum 3+ years of provider healthcare credentialing experience (does not include provider enrollment)

Nice To Haves

Experience with Microsoft Excel, Jira, Google Sheets, and Tableau is a plus

Responsibilities

Verify and maintain licensing, credentials, and insurance records and other PSVs as required
Conduct research on updated state and federal regulations and policies
Help develop internal credentialing processes
Perform duties using our established work systems and methods; maintain our structured workflows to support standardized processes and strive to continuously improve them
Manage and assist in the timely resolution of both internal and external requests
Be responsible for data entry and maintain provider information in Andros’ database
Be responsible for completing provider and facility initial and re-credentialing applications
Collaborate with immediate and internal teams (Credentialing Manager and team) to build quality metrics:
Eliminate errors in our work and client deliverables
Reduce waste and re-work
Help build and support a metrics-driven, structured workflow to standardize processes across all clients, while accommodating unique client specifications
Support the process for driving both incremental improvements and the next generation of Credentialing
Continuously build on subject matter knowledge, including role-specific and leadership/facilitation competencies
Increase domain expertise by ensuring all Credentialing activities and artifacts are documented, remain current, and trained to teams appropriately