Credentials Examiner I (Remote) $15/hr

American Specialty Health is seeking a Credentials Examiner I to join our Practitioner Contract Administration team. This position will expedite credentials verification of practitioners in the credentialing or recredentialing process according to department standards, accreditation standards, regulatory requirements, and health plan expectations.

Remote Worker Considerations:

Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).

Responsibilities

Responsible to obtain information to credential new applicants and recredential participating practitioners according to department standards.

Obtain required documentation by mail, fax, or phone and update practitioner files.

Communicate with practitioners by mail, fax, or phone to answer questions and obtain information in a timely manner.

Respond to provider inquiries within 48 hours of receipt via phone and/or email communication.

Communicate with management any barriers for further support.

Must successfully close a combined minimum number of 200 Rehabilitative files and 150 Specialty Credentialing files as set by department manager and subject to change based on business need.

Must successfully close a minimum number of 200 Re-Credentialing files as set by department manager and subject to change based on business need.

Ensure terminations and resignation requests are sent by set timeline established by department manager and can be subject to change based on business need.

Enter data and perform research functions in Promis/PCT/SharePoint/ASHCore to complete each portion of the credentialing process within predetermined timelines.

Must complete regulatory trainings within the timeframe provided by department manager.

Perform all duties necessary in handling the credentialing and recredentialing process within predetermined timelines and state regulatory standards.

Quality Assurance measures should maintain accuracy rate of no less than 99%.

Abide by departmental work from home expectations.

Abide by Attendance & Punctuality policy and department expectation.