Credentialing Assistant (AZ Remote)

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

PURPOSE OF THE JOB

The Credentialing Assistant facilitates the intake, data entry, and finalization of Credentialing requests.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

* Required Work Experience

* 1 year of administrative experience

* Required Education

* High-School Diploma or GED in general field of study

* Required Licenses

* N/A

* Required Certifications

* N/A

PREFERRED QUALIFICATIONS

1. Preferred Work Experience

* 1 year of administrative experience, preferably within a credentialing/recredentialing environment and knowledge

national accreditation or regulatory criteria.

2. Preferred Education

* Associates degree in a related field

3. Preferred Licenses

* N/A

4. Preferred Certifications

* N/A

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

* Intake, data enter, and scrub initial credentialing requests

* Import CAQH, CVO, and delegated entity txt files into the eVIP's application

* Oversee and triage incoming department emails

* Monitor workflows in the eVIPs application assign files to Credentialing Coordinators as applicable

* Provide status updates and notification of credentialing completion to internal departments

* Clearly communicate credentialing rejections to Network Services staff

* Submit credentialing files to the Credentials Verification Organization (CVO). Monitor credentialing files through processing with the CVO and ensure timely delivery to Credentialing Coordinators

* Manage and import of daily receipt of Credentialing Data Transmission (CDT) files from CVO into eVIPs application

* Escalate any issues identified in relation to work in progress (WIP) or credentialing files received by CVO to department leadership

* Ensure providers CAQH applications are current, and all required documents are present in order to begin credentialing process with CVO

* Coordinate with Network Services, providers, or other sources as necessary on follow-up items needed to complete the credentialing process

* Maintain credentialing status within the eVIPs application. Update credentialing approval dates. Generate welcome letters and recredentialing approval letters and distribute to providers

* Maintain ongoing participating in cross-training activities

* Actively engage in addressing special projects as they arise

* Provide recommendations and feedback regarding development of process improvements and/or standardization practices

* Perform all other duties as assigned

* The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements

COMPETENCIES

REQUIRED COMPETENCIES

1. Required Job Skills

* Familiarity with Microsoft Office software (Outlook, Word, Access, Excel, PowerPoint)

* Ability to analyze and evaluate data and other provider related problems in order to develop alternative solutions for a positive outcome

* Ability to multi-task and prioritize workload, manage multiple priorities, and pay meticulous attention to detail

* Excellent organizational skills

* Strong verbal and written communication skills

* Maintains information in a confidential manner according to policy

2. Required Professional Competencies

* Outstanding interpersonal skills, able to quickly establish a trusting rapport with individuals at all levels

3. Required Leadership Experience and Competencies

* N/A

PREFERRED COMPETENCIES

1. Preferred Job Skills

* Familiarity with credentialing database software

* Thorough understanding of managed care credentialing

2. Preferred Professional Competencies

* N/A

3. Preferred Leadership Experience and Competencies

* N/A

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.