Skip to main content

Credentialing Spec Sr (PS35857)

Location: , OH
Job Family: Provider Network Management
Req #: PS35857-Ohio
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 Sr ensures the integrity of credentialing data and provides expertise and guidance to other credentialing associates. 

Primary duties may include, but are not limited to: 
  • 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. 
  • Monitors reports identifying practitioners on sanctions or those who do not meet credentialing criteria for further action and assists in researching related issues. 
  • Identifies on-going training needs. 
  • Assists in developing training materials. 

Qualifications

Requires: 

  • H.S. diploma; 4-5 years credentialing experience; or any combination of education and experience, which would provide an equivalent background. 
  • CPCS or CMSC 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.
Share: mail

Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.