Credentialing Assistant 3

Become a part of our caring community and help us put health first
 The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

Implements and monitors procedures and activities related to certification and credentialing of providers within the Tricare East Region and Humana Government Business operations. The position is responsible for communicating with providers, external vendors, internal associates, and other third parties by phone, e-mail, fax, etc. regarding certification and credentialing information and status. Must ensure compliance with state, federal, and internal certification and credentialing requirements. Utilizes internal and external information systems to collect and verify information for certification and credentialing activities. Ensures accuracy of provider information in Humana Government Business systems.

KEY ACCOUNTABILITIES

• Review provider certification and credentialing applications for completeness and accuracy. Perform certification and credentialing activities via data collection, confirmation, and verification. Ensuring accurate and timely data entry.

• Intervene as necessary to resolve issues involving unusual cases and processes, responding to internal associates and external provider/provider office staff, i

• Supports the certification and credentialing processes.

Use your skills to make an impact
 

Required Qualifications

• Our Department of Defense Contract requires U.S. citizenship for this position

• HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.

• Proficiency in all Microsoft Office applications, including Word and Excel

• Experience in provider relations, customer service in healthcare field or credentialing

• Familiarity with medical terminology and/or ICD-10 codes

• Data entry experience

Preferred Qualifications

• Knowledge of URAC credentialing standards

• Associate's or Bachelor's Degree in Business, Finance or a related field

Work at Home/Remote Requirements

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense

• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required  

• Satellite and Wireless Internet service is NOT allowed for this role.

• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per …