Credentialing Representative | BomaLink

Credentialing Representative

Bilingual/Interpretation/Translation

Posted 10 months ago

Details

**Description**The Credentialing Representative 2 obtains and reviews documentation to determine status in a health plan. The Credentialing Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.**Responsibilities**The Credentialing Representative 2 reviews the applicant's education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Reviews the information and documentation collected, as well as verification that the information is accurate and complete. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.**Required Qualifications**+ Ability to work independently in a remote environment and ability to work on a virtual team+ Proficient with data entry and strong attention to detail+ Proficiency in all Microsoft Office applications, including Word and Excel+ Excellent communication skills, both verbal and written+ Previous experience in a dental or medical provider setting (assistant or front office) or a minimum 2 years of dental or medical practice and/or insurance industry experience+ Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems+ WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.**Preferred Qualifications**+ Experience and knowledge in CAQH Application process+ Understanding Primary Source Verification in the Credentialing process+ Proficiency with Salesforce Workflows and Activity+ Associate's or bachelor's degree or equivalent experience**Additional Information**Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. #LI-Remote**Scheduled Weekly Hours**40Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our

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