Responsible for credentialing of providers and facilities and associated activities in support of the credentialing process in accordance with established Health Plan credentialing policies following NCQA, Medicare, the state of West Virginia, West Virginia Medicaid and the state of Ohio policies and procedures.
- Associates Degree and/or 2+ years related healthcare experience;
- Excellent communication skills, both written & verbal;
- Attention to detail and commitment to excellence;
- Ability to troubleshoot, problem solve and work independently;
- Experience in working with Microsoft Office programs, Word, Outlook and Excel.
- Acrobat Adobe PDF knowledge.
- 4 year college degree or related certification;
- Credentialing knowledge;
- Experience with data systems;
- Knowledge of medical coding and terminology.