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Credentialing coordinator • tempe az
Provider Credentialing Specialist
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Job Summary
The Provider Credentialing Specialist supports the Credentialing Department by managing and maintaining accurate, up-to-date provider data to include updates, changes, additions and terminations in the credentialing, while working under timeline, accuracy and production targets. Performs credentialing activities including primary source verifications, communicating with Providers to request missing information supporting the integrity of Provider data in all downstream systems, and key-entering initial data of potential network Providers into the credentialing system.
Education & Experience
Required :
- High School Diploma or GED
- If supporting TRICARE contract, must be a U.S. Citizen
- If supporting TRICARE contract, must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
- 6 months or more of provider credentialing experience
Preferred :
Key Responsibilities
Competencies
Commitment to Task : Ability to conform to established policies and procedures; exhibit high motivation.
Communication / People Skills : Ability to influence or persuade others under positive or negative circumstances; adapt to unique styles; listen critically; collaborate.
Computer Literacy : Ability to function in a multi-system Microsoft environment using Word, Excel, Outlook, TriWest Intranet, the Internet, and department software applications.
Organizational Skills : Detail-oriented with the ability to organize people or tasks, adjust priorities, learn systems, within time constraints and with available resources.
Problem Solving / Analysis : Able to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.
Technical Skills : Proficient with key databases, including credentialing software systems, Provider Data Management Systems, and Provider Information Management Systems; working knowledge of Provider credentialing policies and procedures, healthcare or managed care experience
Working Conditions
Working Conditions :