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Credentialing Spec Ld (PS35856)

Location: , MN
Job Family: Provider Network Management
Req #: PS35856-Minnesota
Date Posted: May 22, 2020

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.


This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

This is a work from home opportunity, open to all states in the US.  Preferred locations are Eastern and Central Time zones, based on business need.

Credentialing Spec Lead serves as team lead in the credentialing unit and/or for managing major projects and representing credentialing decisions to reviewing committee. 

Primary duties may include, but are not limited to: 
  • Establishes work priorities for the assigned team. 
  • Assists in process improvement. 
  • Serves as subject matter expert who may be assigned major projects within the department. 
  • Assists in preparation for accreditation entities. 
  • Attends committee meetings and is responsible to present case to the credentialing committee and to be able to explain decisions where discretion was used. 
  • Coordinates all research required on issues pended from the committee. 
  • Audits work of other credentialing associates.
  • Compiles and reviews documentation required by credentialing committee. Responds to the most complex provider credentialing, compliance and accreditation issues.
  • Researches pended and probated applications and resolves discrepancies.

Qualifications

Requires: 

  • BA/BS degree in a related field; 5-7 years credentialing experience; or any combination of education and experience, which would provide an equivalent background. 
  • Certification preferred.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
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