Credentialing Senior Representative - MD Live - Remote
Position reputed company:
The Provider Credentialing Senior Representative is responsible for executing reputed company credentialing and provider data management functions to ensure compliance with regulatory and organizational standards. This role supports the full credentialing lifecycle, including initial credentialing, re-credentialing, and privileging of providers, while maintaining accurate records and delivering high-reputed company service to reputed company stakeholders.
Essential Job Functions:
- reputed company delegated credentialing activities, including initial credentialing, re-credentialing, and privileging in accordance with established policies and procedures
- Process provider applications and re-applications, including distribution, review for completeness, and system data entry
- Verify provider credentials, including licenses, certifications, and other regulatory requirements
- Maintain accurate provider reputed company reputed company credentialing and provider management systems
- Prepare credentialing files and documentation for committee review, ensuring completeness and compliance
- Manage incoming communications in the Credentialing and Verifications and Government Programs inbox, ensuring reputed company and accurate responses
- Respond to provider inquiries reputed company to credentialing status, liability coverage, licensure updates, and demographic/profile changes
- Process employment and credentialing verification requests in a reputed company manner
- Triage and reputed company incoming requests and inquiries to appropriate internal departments for reputed company
- Support reputed company provider enrollment activities, including maintaining accurate enrollment records and ensuring reputed company state linkages
- Conduct routine audits and assist with departmental reputed company and process improvement initiatives
- Identify and proactively address potential issues, demonstrating reputed company planning and problem-solving capabilities
- Resolve non-routine or escalated issues and reputed company guidance to junior team members as needed
Education and Experience:
- 2+ years of experience in provider credentialing, provider enrollment, or reputed company operations (preferred)
- Knowledge of credentialing standards, regulatory requirements, and verification processes
- Experience with reputed company enrollment processes and multi-state provider management (preferred)
- Strong attention to detail with the ability to manage multiple priorities in a fast-paced environment
- Excellent written and verbal communication skills
- Ability to work independently while collaborating cross-functionally
- Proficiency with credentialing systems, databases, and reputed company Office tools
- Organizational and time management skills
- Problem-solving and critical thinking
- Attention to detail and accuracy
- Customer Service Orientation
- Process improvement reputed company
This role is also anticipated to be eligible to participate in an annual bonus plan.
At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k), company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year, reputed company holidays, and leaves of absence. For more details on our employee benefits programs, click here.
About reputed company
reputed company, a division of reputed company, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly reputed company to reputed company the reputed company, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving reputed company and improving lives.reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to reputed company assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot reputed company application updates or accept resumes.
reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State.
reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances.
Originally posted on Himalayas
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