Provider Credentialing Specialist II

Role Overview

• Responsible for specific aspects of Credentialing and Re-credentialing processing for a managed care organization
• Adhering to the National Committee for Quality Assurance, State and Federal regulations
• Review, investigate, and process primary source verifications for facility, ancillary, medical and behavioral providers in a timely, efficient manner

Requirements

• HS
• High School Grad or Equivalent REQUIRED
• Minimum of 2 years of directly related experience REQUIRED
• Thorough knowledge of managed care provider credentialing/re-credentialing principles, methods, regulations, and procedures normally acquired through experience with organizations such as a Credentials Verification Organization (CVO), MCO, HMO or Hospital Based Credentialing (MSO)
• CPCS
• Certified Provider Credentialing Specialist preferred
• Experience in using Credential Stream or other similar programs like MDStaff or Cactus preferred.

Benefits

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.