Description
What's Next for you?
This great job!
Kelly® is seeking a Customer Advocate with entry level credentialing position to work at a top insurance client in Richardson, TX. Let us help you grow at work and discover the next step in your career, all while being a vital part of your community
Snapshot:
Pay rate $17.00
Onsite in Richardson - M-F 7:30am to 4pm
Paid training, after training can select own consecutive 8 hour shift as long as the day starts between 7a and 9am.
Summary
Responsible For Review And Completion Of Primary Source Verification Data In An Accurate And Timely Fashion For Credentialing And Recredentialing Of Practitioners For Multi States. Conducting Research In Order To Complete The Application File. Processing Practitioner Application In Accordance With Company, State And Product Requirements For Assigned Files. Respond To Practitioner Office Representatives Or Internal Department Staff Regarding Status Of The Application And / Or Supporting Documentation.
Responsibilities
1. Audit, monitor and/or report defined elements needed to perform defined credentialing and recredentialing activities according to applicable regulatory agencies and HCSC internal credentialing policies and procedures.
2. Ensure specific provider data required for the Credentialing Provider Committee to review and render a decision on network participation for professional providers is accurate. Ensure Professional Providers applying for initial or ongoing network participation Managed Care/Government products are credentialed or recredentialed timely and appropriately for presentation to the Medical Director Professional Provider Credentialing Committee following the NCQA/URAC/CMS and state regulations, guidelines and standards.
3. Work with Network Management to collect deficient data or the direct collection of required data elements identified as a customer service issue; timely preparation is defined as submission of the provider-credentialing file within specified days of being keyed into the system and completion of the recredentialing file prior to the assigned target date, which follows the NCQA, URAC, CMS and/or state regulations and guidelines.
4. Query working databases to verify status of practitioner applications.
5. Verify and ensure the accuracy of information entered from the network practitioner application and/or re-credentialing packet into the Credentialing and Provider Data Systems. Ensure information in the system reflects the practitioner files in support of the MCO and Compliance Policies and standards.
6. Monitors the applications returned from the provider in order to ensure that required information has been submitted and applications are processed timely. If application is incomplete, return to the Network Management or provider with the Incomplete Notice detailing the information that is missing/deficient. Track receipt and return dates of audited applications in the Credentialing system.
7. Maintain a good working knowledge and understanding of all Corporate, Compliance, and departmental policies, procedures, and regulations related to the credentialing verification process that includes the understanding the laws of each state and the NCQAURAC/CMS guidelines and standards.
8. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
9. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
10. Maintain complete confidentiality of company business.
11. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
JOB REQUIREMENTS:
* High school diploma or GED.-Education verification is required
* 2 years business experience. A combination of college level education and experience will be considered
* Clear and concise interpersonal, verbal and written communication skills.
* Organization skills to handle multi-processes and multi-states.
* PC experience in Windows, Word, Excel, Access, and other business related/associated databases.
What happens next:
Once you apply, you'll proceed to next steps if your skills and experience look like a good fit. But don't worry—even if this position doesn't work out, you're still in our network.
That means all of our recruiters will have access to your profile, expanding your opportunities even more.
Helping you discover what's next in your career is what we're all about, so let's get to work.
If qualified and interested, apply to be a eCredentialing Rep today!
As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.
Get a complete career fit with Kelly®.
You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.About Kelly
Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.
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