Credentialing Specialist

About the job

Company Description

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly.

Job Description

TITLE: Credentialing Specialist

JOB DUTIES:

Will be responsible for acquiring and retaining all knowledge and skills necessary for interpreting and responding to credentialing and re-credentialing policies and procedures.

ESSENTIAL FUNCTIONS:

1. Enter updated information into the PIP system via the PC; research provider application information as it relates to assigned function.

2. Ensure renewal updates are received within specified time frames of the credentialing process and satisfy the TDI Regulations for the HMO product.

3. Monitor reports to support the credentialing process for providers in opened process.

4. Perform in-depth research for providers identified as having system discrepancies according to the NTIS (National Technical Information Service) report.

5. Communicate with external agencies (boards, hospitals, provider offices, etc.) via telephone, to provide follow-up on requested verifications.

PAY: $15.00 an hour

HOURS: 8 AM – 5 PM, Monday - Friday

JOB REQUIREMENTS

*9 months credentialing or healthcare field

*PC experience to include Windows, Word, Excel, and business databases

*Strong verbal and written communication skills

*Organizational skills and decision-making ability

*Ability to multi-task

PREFERRED JOB REQUIREMENTS

*Access experience

*Knowledge and understanding of NCQA/MCO/CVO guidelines and requirements

*Knowledge of RNPS and PIP or similar provider databases

*Bi-lingual English/Spanish

BENEFITS:

Competitive starting wages Monday through Friday work schedule Paid holidays Year-end bonus program Portable 401(k) plans Recognition and incentive programs Access to continuing education via the Kelly Learning Center