Credentialing Assistant - Remote (AZ)
Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
This remote work opportunity requires residency, and work to be performed, within the State of Arizona.
The remote work opportunity requires residency, and work to be performed within the State of Arizona.
PURPOSE OF THE JOB
The Credentialing Assistant facilitates the intake, data entry, and finalization of Credentialing requests.
Required Work Experience
1 year of administrative experience
High-School Diploma or GED in general field of study
Preferred Work Experience
1 year of administrative experience, preferably within a credentialing/recredentialing environment and knowledge national accreditation or regulatory criteria.
Associates degree in a related field
Intake, data enter, and scrub initial credentialing requests
Import CAQH, CVO, and delegated entity txt files into the eVIP’s application
Oversee and triage incoming department emails
Monitor workflows in the eVIPs application assign files to Credentialing Coordinators as applicable
Provide status updates and notification of credentialing completion to internal departments
Clearly communicate credentialing rejections to Network Services staff
Submit credentialing files to the Credentials Verification Organization (CVO). Monitor credentialing files through processing with the CVO and ensure timely delivery to Credentialing Coordinators
Manage and import of daily receipt of Credentialing Data Transmission (CDT) files from CVO into eVIPs application
Escalate any issues identified in relation to work in progress (WIP) or credentialing files received by CVO to department leadership
Ensure providers CAQH applications are current, and all required documents are present in order to begin credentialing process with CVO
Coordinate with Network Services, providers, or other sources as necessary on follow-up items needed to complete the credentialing process
Maintain credentialing status within the eVIPs application. Update credentialing approval dates. Generate welcome letters and credentialing approval letters and distribute to providers
Maintain ongoing participating in cross-training activities
Actively engage in addressing special projects as they arise
Provide recommendations and feedback regarding development of process improvements and/or standardization practices
Perform all other duties as assigned
The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements
Required Job Skills
Familiarity with Microsoft Office software (Outlook, Word, Access, Excel, PowerPoint)
Ability to analyze and evaluate data and other provider related problems in order to develop alternative solutions for a positive outcome
Ability to multi-task and prioritize workload, manage multiple priorities, and pay meticulous attention to detail
Excellent organizational skills
Strong verbal and written communication skills
Maintains information in a confidential manner according to policy
Required Professional Competencies
Outstanding interpersonal skills, able to quickly establish a trusting rapport with individuals at all levels
Required Leadership Experience and Competencies
Preferred Job Skills
Familiarity with credentialing database software
Thorough understanding of managed care credentialing
Preferred Professional Competencies
Preferred Leadership Experience and Competencies
Comply with BCBSAZ corporate and departmental policies and procedures, including, but not limited to Code Blue, Compliance, HIPAA, Computer Responsibility, Accreditation Standards, Attendance, Staff Qualifications and Quality Management Accountabilities.
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.