Credentialing Sr Specialist

CVS Health•Farmers Branch, TX

3d•Hybrid

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The credentialing hub is an elite team within the credentialing department who is responsible for a variety of tasks that supports the overall success of the department. The Hub is focused on ensuring compliance with NCQA, URAC, Medicare, Medicaid, Delegation agreements and other pertinent client requirements. This role will report to our Credentialing Hub Supervisor Preference is given to candidates who are local to Dallas area and able to commute to the Signify Health HQ offices in Farmers Branch at 4055 Valley View Lane.

Requirements

High School Diploma
3-5 years of successful work experience in a credentialing role/department
Intermediate skills in Google Suite Applications such as Gmail, Google Calendar, Google Sheets and Slide Presentations

Nice To Haves

NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify.
Preference is given to candidates who are local to Dallas TX and able to commute hybrid to our offices in Farmers Branch

Responsibilities

Serving as the primary point of contact for clinicians and routing information to other departments; this is done by managing the general email inbox [email protected] and answering the inbound phone line 469-466-7420
Verifying State Licenses, exclusions lists, DEA’s, Board Certifications and Medicaid/Medicare Enrollment verifications on an ongoing basis to ensure qualified and approved clinicians remain active in the network.
Enrolling clinicians in Medicare and Medicaid following state and federal guidelines
Applying for state licensure for clinicians
Participating in Pre-Delegations and annual client audits
Managing roster creations and distribution and claims issues as reported by clients related to rosters