Credentialing Assistant

🕒 2 days ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

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

• Enter reviewer application data and perform online searches of reviewers • Conduct primary/prime source verification of board certifications, licenses, background checks, and malpractice checks • Upload documents to electronic reviewer files and produce Judgments pages with Medical Director comments • Apply client Do Not Use status and communicate application status to the Operations team • Send recredentialing applications to reviewers and refer red flags to the Medical Director • Review licenses, certifications, and registrations for expiration status • Create and receive sanctions clearinghouse reports, investigate identified sanctions, and locate supporting documentation • Send sanctions and background information to the Medical Director for review • Obtain W-9 documents, clone profiles after fundamental identifying-data changes, and remove reviewers from panels as requested • Perform data entry for new or updated fee schedules and obtain fee agreements • Participate in Quality Management Committee meetings and complete follow-up activities • Provide credentialing-related advice to leadership, contracting, and Operations functions • Perform other duties and special projects as assigned based on business needs

🎯 Requirements

• Associate’s Degree or Bachelor’s Degree preferred • Credentialing experience in a healthcare or insurance setting preferred • Knowledge of URAC and relevant State and Federal guidelines • Understanding of medical terminology • Excellent communication skills • Critical-thinking ability • Ability to manage time efficiently and meet specific deadlines • Computer literacy and typing skills required • Ability to perform required lifting, bending, traveling, and other physical duties • Ability to tolerate long periods of sitting and computer work • Must supply and support own internet services for work from home • Must maintain an uninterrupted internet connection

🏖️ Benefits

• Medical, dental, and vision coverage for employees and their families • Voluntary life insurance options for employees, spouses, and children • Voluntary hospital indemnity, critical illness, accident indemnity, and pet insurance plans • Basic life insurance at no cost • Short-term disability coverage at no cost • Long-term disability coverage at no cost • Generous paid time off policy • 401k plan with a company match • Apple equipment for remote workspace • Media stipend for remote workspace