Delegated Credentialing Representative

Job Description

Job Description

Under the direct supervision of the Manager of Credentialing, responsible for all delegated provider credentialing activities in accordance with established THP credentialing policies and procedures that are compliant with current year NCQA credentialing and recredentialing requirements, CMS, BMS, and the states of Ohio, Pennsylvania, West Virginia as well as all bordering states.

Required :

• Associates Degree or high school diploma / equivalent.
• Strong organizational, interpersonal, and critical thinking skills.
• Excellent communication skills, both written and verbal.
• Ability to multi-task, prioritize workload to meet deadlines, and pay meticulous attention to detail.
• Ability to troubleshoot, problem solve and work as a team as well as independently
• Experience in personal computer software applications such as Microsoft Office (Word, Excel) and Adobe Acrobat. .

Desired :

Responsibilities :

Equal Opportunity Employer

The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

8 : 00am - 5 : 00pm

40