Credentialing Assistant 3

Employment Type: Full-time Location Type: Remote Salary: [Salary 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, and may apply intermediate mathematical skills.

The Credentialing Assistant 3 implements and monitors procedures and activities related to certification and credentialing of providers within the Tricare East Region and Humana Government Business operations. The position is responsible for communicating with providers, external vendors, internal associates, and other third parties by phone, e-mail, fax, etc., regarding certification and credentialing information and status. This role ensures compliance with state, federal, and internal certification and credentialing requirements, and utilizes internal and external information systems to collect and verify information for certification and credentialing activities. Ensures accuracy of provider information in Humana Government Business systems.

Key Accountabilities

• Review provider certification and credentialing applications for completeness and accuracy.
• Perform certification and credentialing activities via data collection, confirmation, and verification.
• Ensure accurate and timely data entry.
• Intervene as necessary to resolve issues involving unusual cases and processes, responding to internal associates and external provider/provider office staff.
• Support the certification and credentialing processes.

Requirements

• Required Qualifications:
  • Our Department of Defense contract requires U.S. Citizenship for this role.
  • Experience in provider credentialing.
  • Familiarity with medical terminology and/or ICD-10 codes.
  • Proficiency in all Microsoft Office applications, including Word and Excel.
  • Excellent communication skills, both verbal and written.
  • Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems.
  • Data entry experience.
• Preferred Qualifications:
  • Knowledge of URAC credentialing standards.
  • Associate's or Bachelor's Degree in Business, Finance, or a related field.

Application Instructions

• PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT)

Company Information

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

Work at Home Guidance

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

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended.
• Wireless, wired cable, or DSL connection is suggested.
• Satellite, cellular, and microwave connections can be used only if approved by leadership.

Associates 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 associates 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.

Travel

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

Compensation

• Scheduled Weekly Hours: 40
• Pay Range: The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledg