Credentialing Specialist

Mission

The mission of this role is to help coordinate and manage our Facilities and Provider credentialing within our Network Management team, its processes, and services. Support a seamless client experience and deliver on all client SLAs - at all times. Provide transparency, communication, and documentation of credentialing processes, workflows, and other artifacts that can be shared internally and with clients.

Adhere to, support, and drive quality measures for the overall credentialing operation, both within Andros and client-facing operations, ensuring excellence in service delivery, program health, and compliance adherence.

Outcomes

Credentialing Program Execution

• Verify and maintain licensing, credentials, and insurance records and other PSVs as required
• Conduct research on updated state and federal regulations and policies
• Help develop internal credentialing processes
• Perform duties using our established work systems and methods; maintain our structured workflows to support standardized processes and strive to continuously improve them
• Manage and assist in the timely resolution of both internal and external requests
• Be responsible for data entry and maintain provider information in Andros’ database
• Be responsible for completing provider and facility initial and re-credentialing applications

Quality Assurance of Credentialing

Collaborate with immediate and internal teams (Credentialing Manager and team) to build quality metrics:

Eliminate errors in our work and client deliverables

Reduce waste and re-work

Help build and support a metrics-driven, structured workflow to standardize processes across all clients, while accommodating unique client specifications

Process Improvement & Development

Support the process for driving both incremental improvements and the next generation of Credentialing

Continuously build on subject matter knowledge, including role-specific and leadership/facilitation competencies

Increase domain expertise by ensuring all Credentialing activities and artifacts are documented, remain current, and trained to teams appropriately

Role-Specific Competencies

Ownership - You own everything in your domain and take responsibility to get results without excuses or blame. You earn trust through being reliable

Communication - You are concise, articulate, and timely in all communications. You listen actively, understand questions (and clarify when unclear), and speak up even when it might be uncomfortable

Problem Solving - You are able to figure out solutions that others may have missed. You are able to work autonomously and as a team player when it comes to tackling issues that seem impossible. You never settle for “good enough”, rather, you operate with a “how can I/we be better?” mentality

Attention to Detail - You mind the details so nothing slips through the cracks

Flexibility/Adaptability - You adjust quickly to changing priorities and conditions. You cope effectively with complexity and change

Follow-through on Commitments - You live up to verbal and written agreements without fail

High Standards - You lead by example and expect personal performance and team performance to be nothing short of the best

Familiar with provider credentialing and recredentialing requirements

• Strong computer and software skills
• Excellent interpersonal skills, including excellent verbal and written communication skills
• Ability to demonstrate a high degree of trust and confidentiality

Ability to work independently and assume assigned responsibilities

• Skilled in efficiency, organization, time management, and prioritization
• Ability to be flexible and function well in a fast-paced environment
• Ability to deal with problems involving several concrete variables in standardized situations
• Ability to handle confidential information
• Minimum 3+ years of provider healthcare credentialing experience (does not include provider enrollment)
• Experience with Microsoft Excel, Jira, Google Sheets, and Tableau is a plus

Hourly rate of $24.00

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