Credentialing Intake Specialist at CareersUSA

Philadelphia, PA 19103

About the Job

CareersUSA, a leader in the staffing industry with over 36 years of experience, has another job opportunity for you:

Our Client is seeking a Credentialing Intake Specialist in Philadelphia, PA.

Earn $22.30 per hour at this full-time, temporary position.  Work 37.5 hours per week, Monday through Friday from 8:00 AM to 5:00 PM

Job Description:
  • Independently analyze credentialing and re credentialing applications for completeness and accuracy to determine if credentialing criteria is met and is compliant with corporate, state, federal and accreditation requirements and guidelines
  • Enter demographic and credentialing elements into the practitioner’s record in the credentialing database and make appropriate outreach for missing information or additional clarification as needed from the practitioner or other credentialing support departments
  • Complete primary source verification of practitioner credentials as required by corporate, state, federal and accreditation standards, utilizing approved verification sources
  • Verifications and decisions are supported with appropriate documentation and rationale in the practitioner’s electronic record
  • Manage daily workflow by running daily reports from the credentialing database to meet accreditation and / or corporate requirements and time frames
  • Outreach / contacts / verifications are accurately and completely documented into the practitioner’s record in the credentialing database
  • All supplemental documentation received during the credentialing process is scanned and attached to the electronic practitioner record
  • Assure that all verifications, signatures and documentation used in the credentialing process is current and effective to meet the NCQA MCO and CVO requirements
  • Assure the confidentiality and integrity of all aspects of the verification process

  • Bachelor's Degree in related field or equivalent experience
  • Minimum 1 year of credentialing, quality assurance, or auditing experience
  • Excellent research, analytical ability and decision-making skills  
  • Demonstrated organizational ability with attention to detail
  • Excellent communication skills both verbal and written
  • Composes professional, quality correspondence such as letters, emails or memos with an emphasis on grammatical accuracy and content clarity
  • Demonstrated phone skills
  • Proficiency in using a computer
  • Prior experience in working with database applications preferred
  • Demonstrated ability to make good decisions based on common sense
  • Prior Philprov or provider database experience preferred
  • Proficiency in accessing / researching external websites

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