Credentialing Specialist Job at Ohm Systems, Philadelphia, PA

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  • Ohm Systems
  • Philadelphia, PA

Job Description

Duties

  • The Credentialing Specialist is responsible for processing and completing the credentialing and re-credentialing functions of all providers by NCQA, state, and federal requirements.

Principal Accountabilities:

  • Validates completeness of provider applications before processing.
  • Conducts primary source verification for all credentialing and re-credentialing applications.
  • Monitors the progress and completion of all site visits by the provider network team to ensure completion within the established timeframe.
  • Accurately enters all critical data elements of provider applications into the Credentialing system.
  • Respond to phone inquiries received in the Credentialing phone queue from internal and external clients.
  • Completes projects as assigned.

Skills:

  • Intermediate knowledge of PC applications, including Microsoft Office.
  • Strong verbal and written communication skills.
  • Strong organizational skills are required.
  • Ability to perform in a metrics-driven environment..

Education

  • Associates Degree
  • Bachelor's Degree

Job Tags

Hourly pay, Work at office,

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