Delegated Credentialing Rep
Under the direct supervision of the Manager of Provider Information Management, responsible for all delegated provider credentialing activities 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 or high school diploma/equivalent and two years related healthcare experience;
- Strong organizational, interpersonal, and critical thinking skills;
- Excellent communication skills, both written and verbal;
- Ability to multi-task, prioritize workload to meet deadlines, and pay meticulous attention to detail;
- Ability to troubleshoot, problem solve and work as a team as well as independently;
- Experience in personal computer software applications such as Microsoft Office (Word, Excel) and Adobe Acrobat.
- Bachelors Degree;
- Previous credentialing experience;
- CPCS Certification;
- Experience with data systems;
- Knowledge of medical coding and terminology.