Credentialing Specialist I

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Associate’s degree or high school diploma/equivalent with 1+ years of relevant experience., Experience in data entry, customer service, medical office, or healthcare operations is preferred., Familiarity with credentialing processes and NCQA standards is beneficial., Ability to work in a fast-paced environment while maintaining quality..

Key responsabilities:

  • Perform credentialing and re-credentialing activities according to plan specifications.
  • Communicate professionally with physicians and providers to gather necessary information.
  • Process, track, and file credentialing applications within established standards.
  • Generate reports to support business functions.

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Centene Corporation XLarge https://www.centene.com/
10001 Employees
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Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

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 quality

Education/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.

Pay Range: $19.04 - $32.35 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

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.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Customer Service
  • Professionalism
  • Communication
  • Time Management

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