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Credentialing Associate- Mendo...

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Job Summary

Company
Anthem
Location
Mendota Heights, MN
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS2707

Credentialing Associate- Mendota, MN- PS2707

About the Job

Description
Your Talent. Our Vision. At DeCare Dental, a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater 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.

Credentialing Associate:

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.

Primary duties may include, but are not limited to:
- 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.
Qualifications
  • Requires a high school diploma or GED; one year of office experience in a health care environment; or any combination of education and experience, which would provide an equivalent background.
  • Proficiency with MS Excel desired.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

 

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