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Credentialing Assistant

1 hour, 57 minutes ago
United States
Full-time
Junior
Human Resources
Operations
Apply Now
Dane Street

Dane Street

Dane Street provides independent medical examination and peer review services tailored for the insurance industry, focusing on areas such as workers' compensation, disability, and auto liability, while emphasizing quality, compliance, and timely delive...

Insurance
251-1K
Founded 2008
View All Jobs 15

Description

  • Enter reviewer application data and maintain electronic reviewer files.
  • Perform online searches and primary source verification for board certifications, licenses, malpractice history, and background information.
  • Conduct and document sanction, exclusion, and preclusion checks, including supporting research and reporting.
  • Upload credentialing documents and prepare Judgments pages with Medical Director comments.
  • Apply client Do Not Use status and communicate application decisions and status updates with Operations.
  • Send recredentialing applications and verify continuing licensure, certifications, and malpractice coverage.
  • Review expired licenses, certifications, and workers’ compensation registrations and track renewal status.
  • Obtain W-9 forms, update reviewer contact data, and clone or deactivate reviewer profiles as needed.
  • Edit fee schedules, enter new or updated fees, and obtain fee agreements when required.
  • Participate in Quality Management Committee meetings and complete follow-up activities as assigned.

Requirements

  • Associate’s degree or Bachelor’s degree preferred.
  • Credentialing experience in a healthcare or insurance setting preferred.
  • Knowledge of URAC and relevant state and federal guidelines.
  • Excellent communication skills and understanding of medical terminology.
  • Strong critical thinking skills and the ability to manage time efficiently and meet deadlines.
  • Computer literacy and typing skills are required.
  • Ability to perform job duties that may involve lifting, bending, traveling, prolonged sitting, and extensive computer work.
  • Must supply and maintain uninterrupted internet service for a work-from-home role.
  • Willingness to adapt to changing job duties and business needs.

Benefits

  • Medical, dental, and vision coverage for employees and family members.
  • Voluntary life insurance options for employees, spouses, and children.
  • Company-paid basic life insurance, short-term disability, and long-term disability coverage.
  • Voluntary hospital indemnity, critical illness, accident indemnity, and pet insurance plans.
  • Generous paid time off.
  • 401(k) plan with company match.
  • Apple equipment and a media stipend for the remote workspace.

Interested in this position?

Apply directly on the company website

Apply Now

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