Job Description

Facility Credentialing Senior Representative

POSITION SUMMARY

This position is responsible for working within implemented procedures related to credentialing and re-credentialing of medical and behavioral facilities. Must be able to accurately and efficiently process initial credentialing and re-credentialing application as well as follow specific guidelines listed in CR-04 and job aids.

RESPONSIBILITIES

Reviews and process initial credentialing and re-credentialing application for Medical and Behavioral Line of Business.

Manage/Oversees centralized verification of current licensure and certification for Medical and Behavioral facilities and Ancillaries.

Conduct thorough review of obtained credentialing information to ensure compliance with policy and regulatory requirements.

Establish and maintain constant communication with Contracting or other matrix partners to ensure facilities updated information have been acquired and make necessary adjustments as needed.

Serve as a Subject Matter Expert and act as a resource for management and matrix partners.

Obtain Primary Source Verification via secure website.

Ensure timely follow-up and processing to meet agreed upon standards.

Consistently achieves 100 % accuracy on all systems data entry.

Manages assigned mailboxes and responds to inquiry accurately and within the department standards.

Run credentialing committee and bariatric reports timely and accurately.

Complete projects as assigned.

QUALIFICATIONS

* Bachelor's degree or higher strongly preferred or equivalent work experience.
* Prior credentialing experience is highly desirable
* Ability to work constructively in a team environment
* Strong organization and time management skills; effectively adapts to multiple and/or competing priorities
* Excellent communication, collaboration and interpersonal skills in order to work effectively with matrix partners
* Aptitude for detail and ability to follow procedural standards
* Strong analytical and problem solving skills
* Proficient in MS office, Excel, Outlook and Word
* Flexible with change and able to make decisions
* Demonstrate a CAN DO attitude

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, youll enjoy meaningful career experiences that enrich peoples lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search TeamCigna on Instagram.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.