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Credentialing Specialist II
@LE701 Avesis, LLC
[Hiring] Credentialing Specialist II @LE701 Avesis, LLC
Apr 03, 2025 - LE701 Avesis, LLC is hiring a remote Credentialing Specialist II. 💸 Salary: $16.69 - $26.07 per hour. 📍Location: USA.
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
This role involves ensuring our healthcare partners meet regulatory requirements and industry best practices, directly impacting the quality of care delivered to patients.
- Process provider applications for credentialing and re-credentialing
- Maintain compliance with state, federal, and NCQA guidelines
- Ensure smooth, efficient operations within the team
- Facilitate provider onboarding efforts including importing data from CVO into applicable systems
- Ensure required documentation is complete and accurate
- Perform timely follow-up with providers on pending applications/information
- Perform primary source verifications according to departmental policies and NCQA standards
- Build and accurately maintain provider information in various systems
- Respond to inquiries regarding the status of provider’s application
- Utilize organizational templates to communicate with providers about the status of their application
- Provide support to Credentialing Specialist I on functional responsibilities
Qualifications
- Associate degree or equivalent combination of education and experience
- 3 years credentialing experience, preferably in a managed care setting
- CPCS certification preferred
Requirements
- Strong computer, data entry, and clerical skills
- Working knowledge of NCQA standards and payer credentialing standards
- Knowledge of vision, dental, or hearing industry
- Ability to manage and complete details of assignments without too much oversight
- Ability to effectively troubleshoot complex issues, problem solve, and multi-task
- Integrity & responsibility: acting with a clear sense of ownership for actions and decisions
- Ability to represent your own interests while being fair to others
Benefits
- Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way
- Competitive compensation package
- Excellent medical, dental, supplemental health, life, and vision coverage for you and your dependents with no wait period
- Life and disability insurance
- A great 401(k) with company match
- Tuition assistance, paid parental leave, and backup family care
- Dynamic, modern work environments that promote collaboration and creativity
- Flexible time off,
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| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
Back to Remote jobs >
All others
All others
|
Salary
💸
$16.69 - $26.07 per hour
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Apr 03, 2025
|
️
| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
