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Description:
There will be 3 main parts/phases of this project and the responsibilities will encompass the duties below in each phase:CACTUS Implementation:● Review Credentialing Spreadsheets to ensure compliance with Visual Cactus Data Entry Policies● Assist with implementation tasks in Visual Cactus such as data validation, UAT and workflow review and creation of workflow documentationCore Functions: Initial Credentialing and Re-Credentialing● Annual Audits for current Sub-Delegation Credentialing Agreements● Assist with entering information into Credentialing Spreadsheets to ensure data is accurate and up to date● Entering Providers into Visual Cactus● Assist with processing Initial and Re-credentialing files● Health Plan Roster Validations/Roster Management● Entering Data on Anthem Blue Cross Provider Add/Change/Term Roster template and Site Creation FormsPre-Delegation Audit (Pre-requisite for Sub-Delegation Agreement between DHMSO and DHMF)● Perform Pre-Delegation Audit for Credentialing Sub-Delegation Agreement
Skills:
Credentialing, Data entry, cactus, Provider information, Provider enrollment
Top Skills Details:
Credentialing,Data entry,cactus
Additional Skills & Qualifications:
Experience with Visual Cactus2 years of credentialing experience
Experience Level:
Intermediate Level
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
Other
$49k-61k (estimate)
05/03/2024
07/02/2024
The job skills required for Credentialing Specialist include Data Entry, Interviewing, Diversity and Inclusion, Initiative, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist. You can explore the career advancement for a Credentialing Specialist below and select your interested title to get hiring information.
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Quotes from people on Credentialing Specialist job description and responsibilities
A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.
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A credentialing specialist can have certificates that will prove useful to their field.
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Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
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Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.
02/01/2022: Las Cruces, NM
Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
01/18/2022: Pueblo, CO
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Credentialing Specialist jobs
Credentialing specialists can often find work with a high school diploma or the equivalent.
01/25/2022: Kingsport, TN
Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.
03/01/2022: Parkersburg, WV
While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.
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Make Use Of Advanced Software For Monitoring.
01/18/2022: New London, CT
Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
01/31/2022: Portsmouth, OH
Step 3: View the best colleges and universities for Credentialing Specialist.