Credentialing Assistant
New
D
Dane Street, LLCHealthcare Insurance
United StatesFull-TimeEntry
Salary not disclosed
Apply NowOpens the employer's application page
Job Details
- Required Skills
- Data entry
Requirements
- Associate’s or Bachelor’s degree preferred.
- Credentialing experience in a healthcare or insurance setting preferred.
- Knowledge of URAC, State, and Federal guidelines.
- Understanding of medical terminology.
- Strong critical thinking and time management skills.
- Proficiency in computer literacy and typing.
- Excellent communication skills.
- Ability to maintain an uninterrupted internet connection.
Responsibilities
- Perform initial credentialing by entering application data and verifying board certifications, licenses, and background checks.
- Manage reviewer recredentialing processes and refer red flags to the Medical Director.
- Monitor and update expired licenses, board certifications, and registrations.
- Conduct exclusion, preclusion, and sanction checks including National Practitioner Data Bank reporting.
- Handle reviewer profile updates including W-9 requests and deactivations.
- Maintain fee schedules and update fee agreements.
- Participate in Quality Management Committee meetings to ensure URAC compliance.
- Provide credentialing-related guidance to leadership and operations teams.
View Full Description & ApplyYou'll be redirected to the employer's site
