Credentialing Representative

Healthone Alliance

Dalton, US
Ncqa, cms, doi compliance
Provider data management systems
License expiration monitoring
The mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors

Job Summary

  • The mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.
  • The Credentialing Representative is responsible for the credentialing and recredentialing of providers in compliance with NCQA, CMS, DOI, state credentialing standards and HealthOne Alliance policies and procedures.
  • Benefits include 401K with a 4% match and immediate vesting, Accident insurance, Competitive salary, Critical Illness Insurance, Dental Insurance, Employee Assistance Program, Flexible Spending Account, Health & Wellness Program, Health Savings Account, Life & AD&D Insurance, Long Term Disability, Medical Insurance, Paid Time Off, Pet Insurance, Short Term Disability, and Vision Insurance.

Matching Summary

The mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.

Skills & Requirements

Must-have

  • NCQA, CMS, DOI compliance
  • Provider data management systems
  • License expiration monitoring
  • HIPAA regulations compliance
  • Provider communication and support

Nice-to-have

  • Integrity and heart
  • Ethical, empathetic, economical, efficient
  • Welcoming, authentic, truthful, consistent, humble
  • Continuous process improvement
  • Team environment collaboration

Key Requirements

  • High school diploma or equivalent
  • 1-3 years general work experience
  • Minimum 1 year health plan experience preferred
  • Intermediate Microsoft Excel and Word skills
  • Familiarity with insurance terms

Work Rights

Not specified

Tailored Resume

Cover Letter