The Credentialing Analyst is responsible for completing healthcare providers credentialing files, complying with policies and procedures.
Duties and Responsibilities
- Quality and integrity in data.
- Primary source verifications.
- Providers clarifications.
- Identify errors, omissions or incongruencies.
Education, experience, and knowledge:
- Academic degree in Office Systems, Administrative Assistant, Medical Billing, or others related, from an accredited institution.
- At least, one year in credentialing, medical claims, or direct related position.
- MS Office applications and internet use.
- Clearinghouses, EHR, QNXT, PMHS, Portico, EZCap, Cactus, Symplr or other healthcare platforms experience, preferably.
Skills and abilities:
- Problem solving.
- Oriented to constant analysis, focusing on details.
- Results and quality oriented.
- Time management
- Highly organized.
- Reading and interpretation of documentation in english and spanish languages.
While performing the duties of this job, the employee is required to sit most of the time, use hands, fingers, verbal communications and have vision abilities, including focus.
Position Type/ Expected Hours of Work
This is a full-time position. Monday through Friday, general time span: 8:00 a.m. to 6:00 p.m. Occasionally, out of work time span may be required, as job duties demand.
This job operates in a clerical office setting and/or remote setting. This role routinely uses standard office equipment such as computers, phones, mouse, keyboard, etc.
The work environment characteristics described here are representative of those encountered while performing the essential functions of this job. Support tasks, tied to knowledge, can be included.