Role Description
Verifies, researches, and evaluates credentialing data. Coordinates and ensures complete and accurate provider files for review by Credentials Committee.
• Performs queries in credentialing systems to assess the accuracy of credentials verifications.
• Reviews reports and provider applications against credentialing criteria.
• Reviews issues/problems with practitioner files and determines the appropriate course of action.
• Researches and verifies postgraduate training for non-board-certified providers via mail, internet, phone, or fax.
• Evaluates postgraduate training for non-board-certified providers against criteria.
• Documents and updates provider systems with resolution and/or status of provider issues.
• Prepares files for Credentials Committee review.
• Contacts provider offices and institutions to obtain additional information via phone, fax, internet, and mail.
• Participates on special projects as needed.
• Performs all other duties and responsibilities deemed necessary.
• Collaborates, coordinates, and communicates across disciplines and departments.
• Ensures compliance with HIPAA regulations and requirements.
• Demonstrates commitment to the Company’s core values.
• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
Qualifications
• High School Diploma; Associates Degree or better preferred.
• 2-3 years experience with database functions (maintenance and manipulation of data).
• Required licensures, professional certifications, and/or Board certifications as applicable.
• Communication (written, verbal and listening) and problem-solving skills.
• Service oriented, flexible and ability to work under pressure.
• Ability to work independently, effectively and well in both individual and team environments.
• Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Microsoft Word and Excel, etc.
Requirements
• Compensation: The salary range for this position is $18-20 per hour. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity.
• This position is also eligible for health insurance, 401k and bonus opportunity.
EEO Statement
Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status.
Application Deadline
We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
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