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 week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$43,000 - $56,200 per year

 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Apply