Description:

• Candidates should have knowledge of NCQA standards, delegated credentialing, and Primary Source Verification.
• Candidates should have knowledge of health plan credentialing and enrollment including Medicare and Medicaid.
• Ability to prepare and/or update the provider’s CAQH application for newly affiliated and existing healthcare providers for initial and recredentialing activity.
• The ability to build and maintain peer-to-peer relationships with all relevant market and national health plans.
• Establish credentialed status to facilitate billing for multiple specialties.
• Maintain and update credentialing databases completely and accurately and ensures up-to-date tracking of file process.
• In-depth working knowledge of the various applications associated by plan as well as internally and the workflow process defined by department leadership.
• Ensure all workflow items are completed within the set turn-around-times, meeting quality expectations.
• Roster management and reporting experience preferred

2503007319 Minimum Qualifications Full Time

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.

Tenet participates in the E-Verify and Work Opportunity Tax Credit (WOTC) programs. Follow the links below for additional information.

E-Verify: http://www.uscis.gov/e-verify
WOTC: https://www.doleta.gov/business/incentives/opptax