22 days old

Credentialing Specialist- Mendota Heights, MN- PS30384

Anthem, Inc.
Mendota Heights, MN 55118
  • Job Code
    PS30384
Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide.

Your Talent. Our Vision. At DeCare Dental, a proud member of the Anthem, Inc. family of companies, its a powerful combination, and the foundation upon which were creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

Credentialing Specialist

Builds provider credentials file and makes file determinations regarding required credentialing criteria based on general guidelines, ensuring compliance with internal policies and external regulatory agencies.

Primary duties may include, but are not limited to:

  • Receives provider applications and contacts providers for any additional supporting documentation or clarification.

  • Builds file documentation and prepares file for credentialing committee review.

  • Applies general guidelines in determining whether provider meets criteria and documents deficiencies.

  • Prepares correspondence to providers regarding status.

  • Assists in researching pended and probated applications and resolving discrepancies.

  • Refers non-approved providers or questionable situations to senior representative.

  • May assist in provider education and preparation of provider training materials.


Qualifications

  • Requires high school diploma;

  • 1-3 years credentialing or related experience;

  • Or any combination of education and experience, which would provide an equivalent background.
Anthem, Inc. is ranked as one of Americas Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.





Posted: 2019-11-21 Expires: 2019-12-20
Sponsored by:
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Sponsored by:
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Credentialing Specialist- Mendota Heights, MN- PS30384

Anthem, Inc.
Mendota Heights, MN 55118

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