Southcarolinablues
# # # To learn more about our website privacy policy, click on this .* Performs initial and re-credentialing of providers/practitioners including documenting credentialing information according to established policies/procedures.* Completes primary verification of the following: state licensure, state/federal controlled substance certification, educational and/or residency background, malpractice coverage/history, hospital privileges, and previous sanctions.* Maintains credentialing database and HCS data files with appropriate network indicators and effective dates.* Ensures provider databases are kept current and accurate.* Retrieves and interprets credentialing database information for use in various reports.* Communicates (both verbally and in written form) with providers, provider relations, marketing, other credentialing departments, and various management staff relating to any urgent matters.* Registers all participating providers and assists provider network personnel in maintaining and/or updating directory information.* Responds to calls/correspondence from physician/provider/office staff regarding participating networks, directories, and provider credentialing.* Ensures communication of provider profiling and performance information with other provider services areas.* Prepares correspondence and credentialing reports as requested by management.* Assembles necessary information on providers due initial credentialing or re-credentialing for presentation to credentialing committee.* Attends meetings of credentialing committee as scheduled.* Assists in research, redevelopment, and implementation of any new programs/projects. Provides administrative support to delegated credentialing activities.* Associate degree **OR** two years of related work experience.* Two years’ experience in the healthcare **OR** insurance industry.* Good judgment skills.* Effective organizational and customer service skills.* Demonstrated verbal and written communications skills.* Demonstrated proficiency in spelling, punctuation, and grammar skills.* Ability to handle confidential **OR** sensitive information with discretion.* Knowledge **OR** the ability to acquire of organization/committee standards, delegation agreements, etc.* Microsoft Office.* 401(k) retirement savings plan with company match* Subsidized health plans and free vision coverage* Life insurance* Paid annual leave – the longer you work here, the more you earn* Nine paid holidays* On-site cafeterias and fitness centers in major locations* Wellness programs and healthy lifestyle premium discount* Tuition assistance* Service recognition* Incentive Plan* Merit Plan* Continuing education funds for additional certifications and certification renewal
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