Business Analyst
Business Analyst
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
- Responsible for the processing of practitioner and organization/facility provider applications for credentialing and recredentialing; requesting primary source documentation processing documentation requirements verifying information received updating information in the system of record evaluating over all case categorization and reporting findings to the Medical Director and Enterprise Credentialing Committee.
- Resolve inquiries related to credentialing file disposition.
- Provide credentialing status information for group administrators physicians and their staff Provider Services Customer Service and Network Development Inquiries.
- May be designated by the leader to attend Credentials Committee meetings and conduct internal meetings and participate in auditing processes.
- Assist with special projects and job aids as needed.
- Two (2) to five (5) years of work experience in provider enrollment contracting medical practice or hospital business office role and/or credentialing related field required.
- Knowledge of related state/federal regulations NCQA DIFS MDHHS and CMS standards for credentialing required.
- Knowledge of CAQH required.
- Excellent organizational skills with attention to detail required.
- Excellent verbal and written communication skills required.
- Ability to handle and prioritize multiple case files and timelines required.
- Ability to work effectively independently or in a team environment required.
- Intermediate knowledge of Microsoft Word Excel Access PowerPoint and internet use required.
- Preferred Skills/Experience Optional but preferred skills/experience. Include:
- Excellent interpersonal skills and the ability to interact with internal/external customers.
- Associate degree preferred.
Employment Type
Full-time
