Credentialing Representative

Job not on LinkedIn

🔥 43 minutes ago

🏈 Alabama, Florida, +15 more states – Remote

🏈 Alabama – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote

💵 $20 - $30 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Highmark Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1852

🛡️ Insurance

💼 Consulting

📦 Logistics

💰 $5M Grant on 2021-05

Insurance • Consulting • Logistics

Highmark Health is a healthcare company committed to reinventing the healthcare system and improving its services for everyone. The organization offers a broad range of career opportunities across various fields such as clinical care, technology, finance, and marketing. Highmark Health emphasizes diversity, equity, and inclusion in its workforce, creating a supportive environment for employees from all backgrounds. The company has been recognized for its commitment to disability inclusion, diversity, and military-friendly employment. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Health strives to create remarkable healthcare experiences for its customers and employees alike.

📋 Description

• Process provider applications and re-applications, including initial mailing, review and loading • Maintain the provider database • Communicate with providers by phone and mail regarding credentialing status and information • Perform credentialing, re-credentialing and related activities • Coordinate credentialing verifications • Review and process complex additions, updates and deletions of provider information in the Dental Provider file database • Support implementation of new networks, systems, software, guidelines and other initiatives, focusing on group practices • Train credentialing personnel depending on level • Manage credentialing inventory, reports and projects to meet established timelines • Create and distribute monthly reports • Handle complex, unusual and high-level credentialing issues • Support projects, audits, business partners, internal departments and external clients • Represent the department as the subject matter expert • Research and pull documentation for audits • Provide customer oversight for unique requirements and timelines • Investigate interim license actions depending on level • Participate in projects that streamline, automate or enhance credentialing functions

🎯 Requirements

• High School Diploma or GED • 3–5 years of related, progressive experience • Experience in Provider Data Management, Customer Services or Claims • Microsoft Office experience, including Word, Excel and PowerPoint • Familiarity with credentialing processes and URAC standards • Experience with ULTRA and Dental Provider File systems • Experience with Customer Service inquiry systems or claims processing concepts • Good written and verbal communication • Proficiency in provider file use and provider credentialing • Proven diplomacy and professional demeanor • Strong written communication and presentation skills • Compliance with HIPAA, data security guidelines, company policies, applicable laws and regulations

🏖️ Benefits

• Base pay of $20.72–$30.12 per hour • Remote work arrangement • No travel required