Job Description
**Credentialing Specialist**
**Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
The **Credentialing Specialist** builds provider credentials file and makes file determinations regarding required credentialing criteria based on general guidelines, ensuring compliance with internal policies and external regulatory agencies.
**How you will make an impact:**
+ Receives provider applications and contacts providers for any additional supporting documentation or clarification.
+ Builds file documentation and prepares file for credentialing committee review.
+ Applies general guidelines in determining whether provider meets criteria and documents deficiencies.
+ Prepares correspondence to providers regarding status.
+ Assists in researching pended and probated applications and resolving discrepancies.
+ Refers non-approved providers or questionable situations to senior representative.
+ May assist in provider education and preparation of provider training materials.
**Minimum Requirements:**
+ Requires high school diploma or equivalent; minimum of 1 years credentialing or related experience; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities and Experiences:**
+ Strong written and verbal communication skills preferred
For candidates working in person or remotely in the below location(s), the hourly* range for this specific position is $21.07 to $33.04
Locations: California, Minnesota
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Job Tags
Hourly pay, Temporary work, Work experience placement, Work at office, Local area, 1 day per week,
Similar Jobs
Certified Mobile Notary Service
OVERVIEW: As a Notary Signing Agent, your primary responsibilities will include connecting with reputable companies, notarizing mortgage loan documents, and conducting general notary work within your local area, right here in the United States! QUALIFICATIONS:...
THE/STUDIO
...determine if something else might be a good fit! The Role The SEO Manager will be responsible for overseeing all aspects of... ...descriptions, header tags, image alt text, URL structures, and internal linking to improve search visibility. Collaborate with...
Brighton Post Acute
...primary purpose of your job position is to supervise the day-to-day nursing activities of the facility during your tour of duty. Such... ...Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of RAPs and Triggers, Review resident...
Heartland Behavioral Health Services
...Responsibilities Heartland Behavioral Health has been providing care for children and adolescents for over 100 years in Nevada, Missouri... ...TEAM AND HELP US CHANGE LIVES! The Behavioral Health Specialist performs direct patient care duties and services under the...
Veterans Affairs, Veterans Health Administration
...Western New York VA Medical Center is hiring for one - full-time Registered Nurse to work on the Mental Health - Substance Treatment Program... ...care including substance use disorder (SUD) treatment and clinical support. Qualifications Basic Requirements: ~ English...