Credentialing Specialist 1

Position Purpose: Perform credentialing and related activities based on plan specifications Education/Experience: Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment. • Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards • Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information • Gather information for Credentialing Committee meetings • Process, track and file credentialing applications within established standards • Generate and utilize  reporting to support business functions • Ability to thrive in a fast-paced production environment while maintaining quality Day in the Role Triage daily inventory and submit to End to End to end, Possibility of moving to End to end, if moved to end they will complete triaged files and submit for approval. We have bi-weekly team meetings, we have group chats set up for different levels of trainings and for the team. Our work environment is very fast paced. Must Have: Credentialing  Intermediate Excel knowledge  Reading and comprehension 

salary: $17 - $19 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
• Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information
• Gather information for Credentialing Committee meetings
• Process, track and file credentialing applications within established standards
• Generate and utilize  reporting to support business functions
• Ability to thrive in a fast-paced production environment while maintaining quality

Skills

• data entry
• customer service
• medical office

Qualifications

• Years of experience: 1 year
• Experience level: Experienced

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.