What are the responsibilities and job description for the Provider Credentialing Analyst position at Careers Integrated Resources Inc?
Job Title: Provider Credentialing Analyst
Duration: 6 months Contract (May extend as per business need)
Location Remote
Pay Range - $20-$23.23 per hour on w2
Screening Questions:
1. Excel is required - what experience do they have using MS Excel?
2. How familiar are they with creating formulas within Excel on a daily basis?
3. Explain how they use data mining on a daily basis?
4. Are they comfortable working during EST time zone?
Job Details:
Seeking a Credentialing analyst experienced in health care or health plan compliance monitoring and auditing to join our Credentialing and Payer Delegation team. This position supports the credentialing compliance monitoring program activities, auditing, data collection, trend analysis, meeting timeliness and documentation requirements for delegated payer deliverables, NCQA, TJC, CMS, Medicaid and State-Specific audits and inquiries on a daily basis.
Job Duties:
Education:
Duration: 6 months Contract (May extend as per business need)
Location Remote
Pay Range - $20-$23.23 per hour on w2
Screening Questions:
1. Excel is required - what experience do they have using MS Excel?
2. How familiar are they with creating formulas within Excel on a daily basis?
3. Explain how they use data mining on a daily basis?
4. Are they comfortable working during EST time zone?
Job Details:
Seeking a Credentialing analyst experienced in health care or health plan compliance monitoring and auditing to join our Credentialing and Payer Delegation team. This position supports the credentialing compliance monitoring program activities, auditing, data collection, trend analysis, meeting timeliness and documentation requirements for delegated payer deliverables, NCQA, TJC, CMS, Medicaid and State-Specific audits and inquiries on a daily basis.
Job Duties:
- Assists in the preparation of deliverables for payer and internal audit requests.
- Assist with credentialing tasks as needed.
- Building and maintaining effective, positive internal and external customer relationships.
- Conducting ongoing monitoring to evaluate levels of regulatory credentialing and delegated payer compliance with contractual and requirements.
- Exhibiting Client Heart at Work Behaviours.
- Participating in team initiatives and projects and meeting deadlines and quality expectations.
- Participates in the development and ongoing implementation of quality improvement activities. Improve quality products and services, by using measurements and analysis to process, evaluate and make recommendations to meet QM compliance objectives.
- Performing credentialing business process functions as needed, performing scheduled and random credentialing file audits.
- Reviewing risk assessments while participating in ongoing monitoring and annual program evaluation and identification of areas where there can be process improvement
- 3 years of related health care or health plan experience in credentialing compliance, auditing, and quality assurance
- Proficient in Microsoft Office Applications; Excel, Outlook, Word, and Teams
- 2 years experience with CAQH requirements and review
- 2 years NCQA standards related to credentialing.
- The ability to create spreadsheets, analyze data and identify trends.
- 2 years remote work from home experience and the ability to time manage.
- MD-Staff experience is preferred
Education:
- Bachelor s Degree
Salary : $20 - $23
