[Remote] Credentialing Professional - Variable Staffing Pool

Note: The job is a remote job and is open to candidates in USA. Humana is a leading healthcare company focused on providing proactive care to seniors. The Credentialing Professional is responsible for obtaining and reviewing documentation to determine applicant status in a health plan, ensuring accuracy and completeness of information.

Responsibilities

• Obtain and review documentation to determine status in a health plan.
• Review the applicant's education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence.
• Review the information and documentation collected, as well as verification that the information is accurate and complete.
• Understand own work area professional concepts/standards, regulations, strategies and operating standards.
• Make decisions regarding own work approach/priorities, and follows direction.
• Assist with initial, renewal, relocation and termination applications for AHCA, CLIA, Biomedical, HCCE applications.
• Assist with Level 2 prints and license and certification verifications and expirables.

Skills

• Associate's degree or related experience
• A minimum of two years of credentialing experience in healthcare
• Ability to learn credentialing software; ability to complete reporting
• Ability to prioritize workload to ensure deadlines are met
• Excellent written and oral communication skills required.
• Excellent PC skills (including MS Word, Excel and Access) required.
• Bachelor degree in Business, Health Administration, Accounting or related field required.
• Familiar with CAQH
• Bilingual; English & Spanish
• Experience in managed care or health care administration desired

Benefits

• Paid time off
• 401(k) retirement savings plan
• Employee assistance program
• Business travel and accident

Company Overview

• Humana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is http://www.humana.com.