Provider Data Management Credentialing Specialist I

Company: Cenpatico
Location: Rocky Mount
Posted on: January 16, 2020

Job Description:

Provider Data Management & Credentialing Specialist I USA-North Carolina-Rocky Mount Position Purpose: Perform credentialing and provider data management related activities based on plan specifications. * Create credentialing files consistent with NCQA standards Update provider and practitioners status to par by adding claims payment information * Enroll par and non par providers and practitioners into the provider data management system. * Research, review and make updates to user requests within provider data management system * Perform credentialing and re-credentialing activities according to plan specifications Follow up with physicians and providers on missing information * May review files for provisional credentialing checks Education/Experience: High school diploma or equivalent. 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Full-time

Keywords: Cenpatico, Rocky Mount , Provider Data Management Credentialing Specialist I, Executive , Rocky Mount, North Carolina