Provider Credentialing Specialist II - Remote!
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Job Description
City/State Campbell, VA Work Shift First (Days) Overview: Sentara Health Plan is currently hiring a Provider Credentialing Specialist II - Remote!
Status: Full-time, permanent position (40 hours) Work hours: 8am to 5pm EST, M-F Location : Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming Job Responsibilities Under the supervision of a Credentialing Supervisor/Manager, the Credentialing Specialist II is responsible for specific aspects of Credentialing and Re-credentialing processing for a managed care organization, adhering to the National Committee for Quality Assurance, State and Federal regulations.
They review, investigate, and process primary source verifications for facility, ancillary, medical and behavioral providers in a timely, efficient manner.
Education: HS - High School Grad or Equivalent REQUIRED Certification/License: None required Experience: Minimum of 2 years of directly related experience REQUIRED; With thorough knowledge of managed care provider credentialing/re-credentialing principles, methods, regulations, and procedures normally acquired through a.
Acceptable areas demonstrating experience would be direct work experience with organizations such as a Credentials Verification Organization (CVO) , MCO, HMO or Hospital Based Credentialing (MSO).
CPCS - Certified Provider Credentialing Specialist preferred Experience in using Credential Stream is a plus or other similar programs like MDStaff or Cactus preferred Pay Transparency: We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits.
The base pay rate for Full Time employment is: $17. 31 - 23. 08 - 28. 85. Additional c