Credentialing Assistant 3/HGB – WAH Nationwide
Posted on: 9 Apr 2021
Louisville, KY
Job Description
Description
The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.
Responsibilities
The Credentialing Assistant 3 reviews the applicant's education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Reviews the information and documentation collected, as well as verification that the information is accurate and complete. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.
Required Qualifications
* Our Department of Defense contract requires U.S. Citizenship
* High School Diploma
* Proficiency in all Microsoft Office applications, including Word and Excel
* Excellent communication skills, both verbal and written
* Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems
* Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
* Associate's or Bachelor's Degree in Business, Finance or a related field
* Familiarity with medical terminology and/or ICD-10 codes
Additional information
* Schedule: Monday to Friday from 8 am to 5 pm.
* Training: Approximately 2-4 weeks, remote/virtual training
* Work Location (Address): WAH Nationwide
Scheduled Weekly Hours
40
Humana
Louisville, KY
Humana Inc., together with its subsidiaries, operates as a health and well-being company in the United States. The company offers medical and supplemental benefit plans to individuals. It also has contract with Centers for Medicare and Medicaid Services to administer the Limited Income Newly Eligible Transition prescription drug plan program; and contracts with various states to provide Medicaid, dual eligible, and long-term support services benefits.
In addition, the company provides commercial fully-insured medical and specialty health insurance benefits comprising dental, vision, and other supplemental health and voluntary insurance benefits; financial protection products; and administrative services only products to individuals and employer groups, as well as military services, such as TRICARE South Region contract.
Further, it offers pharmacy solutions, provider services, predictive modeling and informatics services, and clinical care services, such as home health and other services to its health plan members, as well as to third parties. As of December 31, 2018, the company had approximately 17 million members in medical benefit plans, as well as approximately 6 million members in specialty products. Humana Inc. was founded in 1961 and is headquartered in Louisville, Kentucky.
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IndustryHealthcare
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No. of Employees41,600
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Website
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Jobs Posted1359
