What are the responsibilities and job description for the Credentialing Specialist I-Remote position at Sunshine State Health Plan?
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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 qualityEducation/Experience: 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 (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Hiring Manager:
Martha Corrales (153273)Job Grade:
J
