Temporary Credentialing Coordinator I

Temporary Credentialing Coordinator I

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY

Verifies, researches, and evaluates credentialing data. Coordinates and ensures complete and accurate provider files for review by Credentials Committee

DUTIES

1. Performs queries in credentialing systems to assess the accuracy of credentials verifications
   2. Reviews reports and provider applications against credentialing criteria
   3. Reviews issues/problems with practitioner files and determines the appropriate course of action.
   4. Researches and verifies postgraduate training for non-board-certified providers via mail, internet, phone or fax. Evaluates postgraduate training for non-board-certified providers against criteria
   5. Evaluates postgraduate training for non-board-certified providers against criteria
   6. Documents and updates provider systems with resolution and/or status of provider issues
   7. Prepares files for Credentials Committee review
   8. Contacts provider offices and institutions to obtain additional information via phone, fax, internet and mail
   9. Participates on special projects as needed
   10. Performs all other duties and responsibilities deemed necessary.
   11. Collaborate, coordinate, and communicate across disciplines and departments.
   12. Ensure compliance with HIPAA regulations and requirements.
   13. Demonstrate commitment to the Company's core values.
   14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
   
   JOB SCOPE:
   The incumbent works under general supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through experience to complete job responsibilities. Work involves support tasks with low to moderate complexity with more complex issues referred to higher levels.

COMPENSATION

The salary range for this position is $18-20 per hour. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.