Job Description

Our Mission:  Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.

Our Vision: 

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.

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
  • Other duties as assigned

Education / Experience / Other Requirements

Education:   

  • 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.

Specialized Knowledge:  

  • 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*

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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