GENERAL SUMMARY
Responsible for supporting credentialing/recredentialing activities in the Credentials Verification Center (CVC). Performs detailed verification and data entry support functions.
ESSENTIAL RESPONSIBILITIES
- Performs primary source verification of practitioners/facilities credentialing information.
- Processes initial credentialing applications. Activities include, but are not limited to, the solicitation, review, and verification of information submitted by providers by performing mail, telephone, database, and internet queries.
- Facilitates the process of recredentialing current physicians in the provider network. Activities include, but are not limited to, solicitation, review, and verification of information submitted by providers by performing mail, telephone, database, and internet queries.
- Maintains accurate provider data in the provider database and other applications as appropriate.
- Utilizes extensive telephone and internet communications to interact with physicians, physician office staff, internal departments, and others as necessary to assist with the credentialing process and related information gathering needs.
- Updates and maintains all active ancillary provider’ files, including verification of current licensure and accreditation status.
- Updates and maintains all active credentialing files to ensure that all information is current.
- Assists with preparation for Credentialing Committee meetings.
- Assists leadership in auditing files.
- Follows credentialing processes and procedures to improve efficiency and quality of files.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- High School Degree or equivalent.
- Previous (1-2 years) experience in credentialing or a similar position.
- Working knowledge of Microsoft Word, Access, Excel, and Internet inquiries.
- Good communication, organizational and interpersonal skills.
- Detail oriented.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Administrative Support Workers
Primary Location: Austin, TX, US
Organization: 51000 - MHNet Specialty Services, LLC
Schedule: Full-time
Job Posting: 2012-12-04 00:00:00.0
Job ID: 1212433