Job Description

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.

The Credentialing Intake Specialist independently analyzes credentialing applications for completeness and accuracy to determine if credentialing criteria is met and is compliant with corporate, state, federal and accreditation requirements and guidelines.

·       Completes primary source verifications of practitioner credentials as required by corporate, state, federal and accreditation standards.

·       Utilizes approved verification sources.

·       Supports decisions and verifications with appropriate documentation and rationale in the practitioner’s electronic record.

·       Manages their daily workflow by running daily reports from the credentialing database to meet accreditation and/or corporate requirements and timeframes.

·       Performs other assigned duties as needed per credentialing department needs.

·       Documents all outreach/contacts/verifications correctly into the practitioner’s record in the credentialing database.

·       Scans and attaches all supplemental documentation received during the credentialing process to the electronic practitioner record

·       Assures that all verifications, signatures and documentation used in the credentialing process is current and effective to meet the NCQA MCO and CVO requirements.

·       Affirms the confidentiality and integrity of all aspects of the verification process.

Qualifications:

·       Bachelor's degree in related field or equivalent experience with a minimum of two years credentialing, quality assurance, or auditing experience.

·       Excellent research, analytical ability and decision-making skills are required. 

·       Demonstrated organizational ability with attention to detail. 

·       Excellent communication skills both verbal and written. Composes professional, quality correspondence – letters, emails or memos -- with an emphasis on grammatical accuracy and content clarity. 

·       Demonstrated phone skills. Proficiency in using a computer. 

·       Prior experience in working with database applications preferred.

·       Demonstrated ability to make good decisions based on common sense.

·       Prior CPR or provider database experience preferred.

·       Proficiency in accessing/researching external websites.

Hybrid

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

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