Credentialing Assistant

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Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

📋 Compliance

🏛️ Government

Healthcare Insurance • Compliance • Government

Dane Street is a national leader in Independent Medical Exams and Reviews, providing objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports. With a large network of over 16,000 physicians, the company offers its services across 25,000 locations and 100 specialties, including Workers' Compensation, Auto, Liability, and Disability claims. Dane Street supports Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities with expert medical analyses, helping them make accurate determinations. The company is recognized for its quality, fast turnaround times, and efficient processes, earning accolades like the NCQA Accreditation in Utilization Management and the Great Place to Work certification.

📋 Description

• Screening reviewers for required credentialing and background information • Initial Credentialing: enters reviewer application data, performs online searches, conducts primary source verification, uploads documents, communicates application status • Recredentialing of Reviewers: sends applications, conducts verification, refers reviewers with red flags, indicates Do Not Use status • Updating Expired Licenses, Certifications, and Registrations: reviews for expiration status • Exclusions, Background and Sanction Checks: creates reports, finds documentation, sends to Medical Director • Reactivating, Deactivating, Do Not Use, Reviewer Contact Data and W9 Requests: obtains W-9 documents, clones profiles, removes reviewers • Editing Fee Schedules: performs data entry of new fees • Participation on the Quality Management Committee: attends required meetings and follow up activities • Assist Team Members with Credentialing Content: provides related advice to leadership

🎯 Requirements

• An Associate’s Degree or Bachelor’s Degree is preferred • Credentialing experience in a healthcare or insurance setting preferred • Knowledge of URAC and relevant State and Federal guidelines • Excellent communication skills as well as understanding of medical terminology • Critical thinking, ability to manage time efficiently and to meet specific deadlines • Computer literacy and typing skills required

🏖️ Benefits

• medical, dental, and vision coverage for you and your family • voluntary life insurance options for you, your spouse, and your children • hospital indemnity, critical illness, accident indemnity, and pet insurance plans • basic life insurance, short-term disability, and long-term disability coverage at no cost • generous paid time off policy • 401k plan with a company match • Apple equipment and a media stipend for remote workspace