Credentialing Analyst / Coordinator

NTT DATA Services currently seeks a Credentialing Analyst to join our team onsite in Cumberland, RI for a 6 month contract role.

Pay rate $25 per hour.

The Credentialing Analyst / Coordinator is responsible for the data analysis and/or the initialing credentialing and re-credentialing of nurse practitioners, physician assistants, Behavioral Health Providers and physicians in a compliant and timely manner; monitor expired credentials and compliance monitoring in accordance with Joint Commission accreditation, NCQA and URAC credentialing standards as required.

Role Responsibilities

• Responsible for the timely and accurate processing of all providers including NP’s/PA’s/MD’s Re-credentialing applications according to the Clinic Credentialing Program
• Monitor Expired licensure reporting , data base tasks and maintain system updates and weekly reporting to leadership
• Manage Epic access for any providers that have out of compliance licensure and/or board certification.
• Conduct sanctions and compliance monitoring and alert Data Analyst Manager and Credentialing Manager of any undisclosed negative findings
• Process malpractice insurance verification requests according to internal policies when applicable
• Maintain the provider and physician SharePoint sites and Communicate provider status’s with leadership and other internal teams to meet timelines
• Submit system access requests upon credentialing approvals/clinic eligibility
• Support the payer enrollment team as needed to resolve any payer claim issues
• Monitor Provider and Clinic change/termination reports and update data base accordingly
• Review and distribute all incoming mail as needed
• Other dutues as assigned
  
  

Required Skills/Experience

• 3 years of Provider Credentialing experience. Demonstrated understanding of initial credentialing and re-credentialing practices for medical professionals including primary source verification methods, compliance monitoring and expireable management.
• 3 years quantitative analysis
• 3 years experience with Joint Commission Accreditation, NCQA and URAC credentialing standards.
• 3 years Microsoft Office, Outlook, Word, and Excel
  
  

3 years experience with MDStaff

Preferences

• Ability to function independently and utilize critical thinking skills to accomplish goals and objectives
• Effective communication skills; verbal and written
• Strong interpersonal skills including the ability to work well with internal and external stakeholders
• Strong organizational skills and the ability to multitask
  
  

Preferred Qualifications

• NAMSS Certified Professional Credentialing Specialist (CPCS) certification
  
  

Education: Associate or Bachelors Degree required

Hours: M-F 8am-4:30pm EST (hybrid schedule - will be required to be in office and possibility for work from home)

NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.