Credentialing Specialist II

🔥 15 hours ago

🇺🇸 United States – Remote

💵 $16 - $32 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Avēsis

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1978

🛡️ Insurance

⚕️ Healthcare Insurance

🧘 Wellness

Insurance • Healthcare Insurance • Wellness

Avēsis is a company dedicated to providing comprehensive specialty benefits focused on improving access, equity, and health outcomes. Specializing in dental and vision plans, Avēsis offers flexible, affordable, and outcome-focused oral health benefits as well as vision plans that connect eye health to overall well-being. With over 40 years of experience, Avēsis is committed to personalized care and building community health networks to service government partners, commercial providers, employers, and brokers. Avēsis operates as a wholly owned subsidiary of Guardian, and leverages tailored network and product solutions to deliver accessible quality care to members, while also administering Medicaid, Medicare, and other essential benefits programs.

📋 Description

• Facilitate provider onboarding, including importing CVO data into applicable systems • Ensure required documentation is complete, accurate, and aligned with industry and organizational standards • Follow up with providers on pending applications and information • Perform primary source verifications according to departmental policies and NCQA standards when not completed by CVO • Build and accurately maintain provider information in various systems • Respond to inquiries about provider application status • Use organizational templates to communicate application status to providers • Support Credentialing Specialist I with functional responsibilities

🎯 Requirements

• Associate degree or equivalent combination of education and experience • 3 years credentialing experience, preferably in a managed care setting • Maintain internet service supporting essential job duties; minimum 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN • Working knowledge of NCQA standards and payer credentialing standards • Knowledge of vision, dental or hearing industry • Strong computer, data entry and clerical skills • CPCS certification preferred

🏖️ Benefits

• Skill-building, leadership development and philanthropic opportunities • Medical, dental, supplemental health, life and vision coverage for employees and dependents with no wait period • Life and disability insurance • 401(k) with company match • Tuition assistance • Paid parental leave • Backup family care • Dynamic, modern work environments promoting collaboration and creativity • Flexible time off, dress code, and work location policies • Employee Resource Groups • Social responsibility and community volunteering opportunities