Our Mission: Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.
Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.
Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!
Position Purpose: Reporting to the Director of Credentialing, the Credentialing Assistant facilitates the intake, data entry, and finalization of Credentialing requests.
- 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
- Other duties as assigned
Education / Experience / Other Requirements
- Associates degree in a related field (or equivalent combination of education and experience)
Years of Experience:
- A minimum of one year administrative experience, preferably within a credentialing/recredentialing environment and knowledge national accreditation or regulatory criteria.
- Familiarity with Microsoft Office software (Outlook, Word, Access, Excel, PowerPoint)
- Familiarity with credentialing database software preferred (symplr, CACTUS, MD-Staff)
- Thorough understanding of managed care credentialing preferred
- 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
- Outstanding interpersonal skills, able to quickly establish a trusting rapport with individuals at all levels
- Maintains information in a confidential manner according to policy
*This position is located in Phoenix, Arizona*