Credentialing Representative

Job Summary

A company is looking for a Credentialing Representative.

Key Responsibilities

• Utilize resources to identify appropriate medical codes and their applicability
• Manage multiple work demands while maintaining productivity and turnaround time standards
• Resolve medical coding edits or denials related to code assignment

Required Qualifications

• High School Diploma/GED (or higher)
• 2+ years of healthcare provider credentialing experience
• 1+ years of experience with compliance workflows and NCQA policies
• 1+ years of experience in researching government regulatory information
• Intermediate proficiency with MS Excel and Word