Credentialing Specialist II (Remote Opportunity!) - (18001645)
The Credentialing Specialist II performs the credentialing and re-credentialing of provider applications in accordance with the departmental policies and procedures and in compliance with applicable State and Federal laws and regulations, as well as National Committee for Quality Assurance (NCQA) standards.
Primary Duties and Responsibilities
Receives and processes incoming applications and supporting credentials from providers
Performs timely follow-up with providers on all pending applications
Performs the primary source verification according to departmental policies and NCQA standards
Builds and accurately maintains provider information in various systems
Responds to inquiries regarding the status of provider’s application
Knowledge, Skills and Abilities
1-3 years credentialing experience, preferably in a managed care setting, preferred
Associate degree or Certified Provider Credentialing Specialist (CPCS) certified preferred
Knowledge of NCQA standards and payer credentialing standards highly desired
Previous experience working with Council for Affordable Quality Healthcare (CAQH) application highly desired
Knowledge of dental industry preferred
Strong computer, data entry and clerical skills required
Excellent interpersonal, oral and written communication skills required
Critical thinking, detail oriented and strong organizational skills required
Continuously strives to provide superior products and customer service
Builds collaborative relationships that are mutually respectful
Demonstrates self-awareness and embraces feedback
Every day, Guardian gives 26 million Americans the security they deserve through our insurance and wealth management products and services. Since our founding in 1860, our long-term view has helped our customers prepare for whatever life brings whether starting a family, planning for the future or taking care of employees. Today, we’re a Fortune 250 mutual company and a leading provider of life, disability and other benefits for individuals, at the workplace and through government sponsored programs. The Guardian community of ~9000 employees and our network of over 2750 financial representatives is committed to serving with expertise when, where and how our clients need us. Our commitments rest on a strong financial foundation, which at year-end 2017 included $8.0 billion in capital and $1.6 billion in operating income. For more information, please visit guardianlife.com or follow us on Facebook, LinkedIn, Twitter and YouTube.
Guardian® is a registered trademark of the Guardian Life Insurance Company of America.
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
Primary Location: United States-Washington-Spokane
Shift: Day Job
Job Type: Standard
Travel: Yes, 10 % of the Time
Job Posting: Oct 16, 2018, 9:08:40 AM