Welcome to Highmark Health, a leading healthcare organization committed to providing the best possible care to our members. We are currently seeking a highly motivated and detail-oriented individual to join our team as a Spec Credentialing I / OPEIU. In this role, you will play a crucial part in ensuring the quality and accuracy of our provider credentialing process, ultimately impacting the care that our members receive. If you have a passion for data analysis and a strong understanding of healthcare regulations, we encourage you to apply. Join us in our mission to improve the health of the communities we serve.
- Manage the provider credentialing process from start to finish, ensuring accuracy and adherence to established policies and procedures.
- Conduct thorough background checks and verifications of provider credentials, licenses, and certifications.
- Communicate effectively with internal and external stakeholders, including providers, to obtain necessary information and resolve any issues or discrepancies.
- Utilize various databases and systems to maintain and update provider information in a timely and accurate manner.
- Analyze data and reports to identify any potential issues or trends, and make recommendations for process improvements.
- Stay informed and up-to-date on healthcare regulations and accreditation standards related to provider credentialing.
- Collaborate with other team members to streamline processes and ensure consistency in credentialing practices.
- Maintain confidentiality and protect sensitive information in accordance with HIPAA regulations.
- Participate in training and development opportunities to enhance knowledge and skills related to provider credentialing.
- Take ownership of assigned tasks and demonstrate a high level of attention to detail to ensure the quality and accuracy of all credentialing activities.
Bachelor's Degree In Human Resources, Business Administration, Or A Related Field.
Minimum Of 3-5 Years Of Experience In Credentialing Or Provider Enrollment, Preferably In A Healthcare Setting.
Knowledge Of Industry Regulations, Such As Ncqa And Cms Guidelines.
Strong Analytical And Problem-Solving Skills, With The Ability To Identify And Resolve Discrepancies.
Excellent Communication And Interpersonal Skills, With The Ability To Build And Maintain Relationships With Internal And External Stakeholders.
Communication Skills
Project Management
Time Management
Analytical skills
Interpersonal skills
Attention to detail
Organizational Skills
Critical Thinking
Computer proficiency
Research skills
Problem-Solving
Communication
Conflict Resolution
Customer Service
Leadership
Time management
creativity
Attention to detail
Teamwork
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a Spec Credentialing I / OPEIU is $40,000-$60,000 per year. However, this can vary depending on factors such as location, years of experience, and specific job duties.
Apply with Video Cover Letter Add a warm greeting to your application and stand out!
Highmark Inc. is among the largest health insurers in the United States and the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.2 million members. Its diversified health businesses serve group customer and individual health needs across the United States through dental insurance, vision care and other related health businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.
Get interviewed today!
JobzMall is the world‘ s largest video talent marketplace.It‘s ultrafast, fun, and human.
Get Started