Credentialing and Enrollment Coordinator
Foodsmart- Full Time
- Junior (1 to 2 years)
Employment Type: Full-time Location Type: Remote Salary: [Salary information not provided]
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.
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.
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:
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.
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Health insurance provider for seniors and military
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.