Full-time jobs in Salt Lake City, UT

About the role

The Credentialing Specialist is responsible for credentialing and recredentialing client practitioners as well as ensuring enrollment with participating client health plans. Credentialing functions include, but are not limited to, processing credentialing applications, performing primary source verifications and updating and maintaining credentialing database in accordance with internal policies and procedures, client health plan contracts and applicable state and federal requirements. This is a temporary position, expected to last no more than one year.

What you'll bring

• Proficient using payor websites including but not limited to CAQH, Pecos, NPI/NPPES, Availity, NaviNet, CMS I&A
• Proficiency ins using various software used for provider applications, verifying credentials and tracking verification statuses
• Knowledge of primary source verification--understand the process of verifying information directly from the original/authorized source that meets relevant regulations, accreditation requirements and compliance standards
• Experience should include 3-5 years of responsibility for medical credentialing processes, policies and procedures and delegated credentialing requirements
• Able to communicate clearly and concisely, both verbally and in written correspondence
• Able to work well under tight deadlines and respond to rapidly changing demands and provide efficient follow up
• Detail oriented with ability to recognize vital information from credentialing documents
• Demonstrate problem-solving, critical thinking, and deductive reasoning skills
• Ability to consistently maintain quality and production expectations
• Ability to learn and use credentialing database and other related databases
• Capable and comfortable dealing with sensitive and confidential information with discretion and trust
• Proficiency with MS Office suite