Credentialing Assistant 3

Employment Type: Full time Work Hours: Start between 7 a.m. - 9 a.m. and work M-F, 8-hour days Scheduled Weekly Hours: 40 Pay Range: [Information not provided] Location Type: [Information not provided]

Position Overview

Become a part of our caring community and help us put health first. The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. This role performs advanced administrative/operational/customer support duties that require independent initiative and judgment. The Credentialing Assistant 3 works in a production-driven environment with some outreach to providers via phone.

The Credentialing Department reviews and verifies providers’ credentials and qualifications to be in network. The department initially credential providers upon joining the network and then recredentials them every 3 years. We ensure Humana’s policy remains in line with NCQA, URAC, and state requirements to maintain accreditation. As a Credentialing Assistant 3, you will play a large role in initial credentialing and recredentialing of our providers.

Responsibilities

• Performs initial credentialing via APEX.
• Performs recredentialing via APEX.
• Corrects errors as identified by leadership via APEX.
• Outreaches to the provider/facility as needed to obtain missing/expired information.
• Manages their own time to accomplish all necessary tasks on time.
• Drives timely credentialing and recredentialing initiatives needed to maintain Humana’s network.

Required Qualifications

• 1+ years of administrative, support, data entry, or related professional experience.
• 1+ years’ experience in a metric/production-driven environment.
• Prior professional experience using Microsoft Office Programs, including Word, PowerPoint, and Excel.
• Demonstrated ability to articulate ideas effectively in both written and oral forms.

Preferred Qualifications

• Associate's or Bachelor's Degree in Business, Finance, or a related field.
• Healthcare experience.
• Credentialing, Contract Load, Service Fund, Directories, or CIS experience.
• Provider Network Operations or National Network Operations Experience.
• Familiarity with medical terminology.

Additional Information

Interviewing Technology

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work At Home / Internet Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required.
• Wireless, wired cable, or DSL connection is suggested.
• Satellite, cellular, and microwave connections can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Information

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.