Senior Credentialing Representative

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Execute core credentialing and provider data management functions to ensure compliance with regulatory and organizational standards • Support the full credentialing lifecycle, including initial credentialing, re-credentialing, and privileging of providers • Maintain accurate records and deliver high-quality service to internal and external stakeholders • Perform delegated credentialing activities in accordance with established policies and procedures • Process provider applications and re-applications, including review for completeness and system data entry • Verify provider credentials, maintain accurate provider profiles within credentialing systems • Prepare credentialing files and documentation for committee review • Manage communications in the Credentialing and Verifications inbox, ensuring timely responses • Support Medicaid provider enrollment activities and maintain accurate enrollment records • Conduct routine audits and assist with departmental projects and process improvement initiatives

🎯 Requirements

• 2+ years of experience in provider credentialing, provider enrollment, or healthcare operations (preferred) • Knowledge of credentialing standards, regulatory requirements, and verification processes • Experience with Medicaid enrollment processes and multi-state provider management (preferred) • Strong attention to detail with the ability to manage multiple priorities in a fast-paced environment • Excellent written and verbal communication skills • Ability to work independently while collaborating cross-functionally • Proficiency with credentialing systems, databases, and Microsoft Office tools • Organizational and time management skills • Problem-solving and critical thinking

🏖️ Benefits

• medical, vision, dental, and well-being and behavioral health programs • 401(k) • company paid life insurance • tuition reimbursement • minimum of 18 days of paid time off per year • paid holidays • leaves of absence