Human Resources Job In Chesapeake, Virginia
CREDENTIALING SPECIALIST INext Steps... Apply Now
Network Contracting/Provider Relations
The Credentialing Specialist I is responsible for credentialing and recredentialing of behavioral health providers and facility organizations (hospitals, mental health centers, etc).
ABOUT THE POSITION
We are currently seeking a dynamic CREDENTIALING SPECIALIST I to join our team. The Credentialing Specialist I is responsible for credentialing and recredentialing of behavioral health providers and facility organizations (hospitals, mental health centers, etc). The Credentialing Specialist I is responsible for collecting credentialing documentation and accurately building provider credentialing files according to contractual and NCQA standards using Beacon's Network Connect Credentialing System. The Credentialing Specialist I position requires independent business decisions to be made to complete credentialing files prior to submission to the Credentialing Committee. The Credentialing Specialist I is responsible for functions including but not limited to initial review of practitioner and facility applications, management of recredentialing files, and obtaining primary source verification for completion of credentialing and recredentialing files. The Credentialing Specialist I also acts as a resource to department team members and external departments in the day-to-day functions of the Credentialing Department.
Location: Latham NY, Chesapeake VA or Remote (reside within the State of NY or VA)
- Credential and recredential behavioral health providers and facility organizations (hospitals, mental health centers, etc.) using Beacon's NetworkConnect credentialing system.
- Perform verbal, written and on-line primary source verification for individual and facility organizations including but not limited to, state licensure, prescribing certificates/registrations, education, training and certification verification, accreditation status and exclusion data-base checks.
- Accurately and timely perform data entry of all primary source verifications and select provider demographic and practice location information into Beacon's NetworkConnect credentialing system.
- Stay current with knowledge of NCQA credentialing standards.
- Credential and prepare credentialing and recredentialing files for weekly Medical Director submission and bi-weekly National Credentialing Committee submission.
- Monitor work queue to ensure applications are processed within expected turnaround times.
- Meet or exceed production and quality standards.
- Display a positive, constructive, and helpful demeanor.
- Other duties as assigned.
- High school diploma required
- Associate's degree or higher in a health related field preferred
Knowledge, Skills & Abilities
- 2 years' experience in insurance, medical, healthcare or related field required.
- Professional demeanor, strong written and oral communication skills, strong computer skills, and the ability to learn Beacon's internal systems.
- Ability to learn quickly.
- Detail-oriented, analytical, highly organized and possessing problem-solving skills.
- Ability to manage varying job pressures, and meet deadlines and handle multiple tasks simultaneously with minimal supervision.
- Ability to work in a production environment and meet production and quality goals.
- Computer literacy and experience with Microsoft office programs (Outlook, Word and Excel), and internet searches. Knowledge working with fax machines, copiers and other office machines.
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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled
At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.
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