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Job Requirements of Provider Credentialing Analyst I:
-
Employment Type:
Contractor
-
Location:
Rhode Island, US (Onsite)
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Provider Credentialing Analyst I
Careers Integrated Resources Inc
Rhode Island, US (Onsite)
Contractor
Job Title : P rovider Credentialing Analyst I
Location: Fully Remote
Job Duration : 6+ Months
Shift: Mon-Fri 8:30a-5p EST
Position Summary:
Role/Responsibilities:
Required Skills:
Education:
Location: Fully Remote
Job Duration : 6+ Months
Shift: Mon-Fri 8:30a-5p EST
Position Summary:
- Seeking an 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 and meeting timeliness for delegated payer deliverables.
Role/Responsibilities:
- 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 Behaviors
- 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
Required Skills:
- 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
- The ability to create spreadsheets, analyze data and identify trends.
- Strong attention to detail and the ability to multi-task in a fast-paced environment
- MDStaff experience is preferred
Education:
- Bachelor s Degree
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