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Credentialing Specialist
Credentialing SpecialistInnova Solutions • Philadelphia, PA,Pennsylvania,United States
Credentialing Specialist

Credentialing Specialist

Innova Solutions • Philadelphia, PA,Pennsylvania,United States
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A client of Innova Solutions is hiring for a Credentialing Specialist .

Position type : Full time - Contract

Duration : 6+ Months

Location : Philadelphia, PA

As a Credentialing Specialist , you will :

  • Be responsible for leading, coordinating and participating in the delegation oversight of credentialing vendors to ensure adherence to regulatory and contractual requirements.
  • Perform credentialing file audits, review of policies and procedures to ensure adherence to state and federal regulations, and accreditation standards and internal Credentialing guidelines.
  • Review submitted rosters from delegates for accuracy and completeness, creates reports regarding audits and analysis, tracks, and trends audit findings. Develop and manages corrective actions to completion and provides feedback to delegates on performance..

The ideal candidate will have :

  • 3-5 years of experience in regulatory, accreditation or compliance role within the health insurance, health, or managed care industry.
  • Associate Degree in Business or Medical OR 4 years’ experience in directly involved in Credentialing operations performing delegated oversight activities.
  • Experience in auditing Credentialing file or credentialing operational experience
  • Knowledge and experience of regulatory, NCQA accreditation requirements and credentialing standards.
  • Experience and knowledgeable in conducting a Medicare Compliance Program Effectiveness audit (preferred)
  • Strong PC proficiency to include Word, Excel, PowerPoint, Adobe Acrobat, and Outlook.
  • Qualified candidates should APPLY NOW for immediate consideration!  Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.

    Thank you!

    Garv Bhalla

    678-207-5236

    Garv.bhalla@innovasolutions.com

    PAY RANGE AND BENEFITS :

    Pay Range

  • : $40 - $43 per hour
  • Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.
  • Benefits : Innova Solutions offers benefits( based on eligibility) that include the following : Medical & pharmacy coverage, Dental / vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

    ABOUT INNOVA SOLUTIONS : Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

    Recent Recognitions :

  • Named One of America’s Best Employers for New Grads by Forbes (2024
  • Named One of the Best Companies to Work For by U.S. News & World Report (Private Companies List, 2024-2025)
  • One of the Largest IT Staffing Firms in the US – Ranked #3 by Staffing Industry Analysts (SIA, 2024)
  • One of the Largest Staffing Firms in the US – Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
  • Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
  • One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
  • AWS Advanced Tier Services Partner with 100+ certifications
  • Website : https : / / www.innovasolutions.com /

    Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates.  If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@innovasolutions.com or (770) 493-5588. Please indicate the specifics of the assistance needed.  Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities.   Innova Solutions (HireGenics / Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.

    The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

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    Credentialing Specialist • Philadelphia, PA,Pennsylvania,United States