Position Purpose: Perform credentialing and related activities based on plan specifications
Education/Experience: Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment.
• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
• Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information
• Gather information for Credentialing Committee meetings
• Process, track and file credentialing applications within established standards
• Generate and utilize reporting to support business functions
• Ability to thrive in a fast-paced production environment while maintaining quality
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
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Perform credentialing and related activities based on plan specifications
Education/Experience: Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment.
• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
• Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information
• Gather information for Credentialing Committee meetings
• Process, track and file credentialing applications within established standards
• Generate and utilize reporting to support business functions
• Ability to thrive in a fast-paced production environment while maintaining quality
Story Behind the Need
- What is the purpose of this team?
- What is driving this need? (ex. Backfill for FTE or CW, new project, business growth)
- Describe the surrounding team (team culture, work environment, etc.) & key projects.
- Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?
- The Credenitaling team performs credentialing and related activities based on plan specifications.
- The position is to temporarily replace a team member that has taken the VSP option.
- These positions will be on our Dental side of credentialing. Our team consists of 4 team members currently, of which 1 is a contingent worker and another has taken the VSP, and end date is December 2026. Team is very collaborative and training is always provided and ongoing. No key projects. Candidates will manually be inputting data, communicating with office, providers, office managers and other third parties to secure information relating to credentialing providers. Candidate will be working with Excel reporting and need to be able to work in fast paced scenarios all while managing time wisely and executing tasks accurately. Education verification is a requirement for this position.
- At this time, our department has no upcoming hiring needs, other than this 1 position and is not part of a request of a larger hiring initiative.
Typical Day in the Role
- Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
- What are performance expectations/metrics?
- What makes this role unique?
- Employees will maintain personal email requests and responses within a 3–5-day TAT window.
- Employees will manually enter documents in our system daily within the day assigned.
- Employees will work tasks assigned within the timeframe given accurately.
- Performance expectations are to perform assigned tasks accurately and in timely manner. Metrics are given per assignment task.
- This role is unique in that credentialing is a structured process that verifies an individual’s qualifications, professional competence, and compliance with industry standards as well as company standards.
Candidate Requirements
Education/Certification
Required: HS Diploma
Preferred: same
Licensure
Required: none
Preferred: none
Years of experience required: Years of experience required: 1 year of data entry and customer service, medical office, or credentialing. Must have experience in education verification for providers going through the initial credentialing process.
Disqualifiers: do not have HS diploma or at least 1 year of data entry and customer service experience
Additional qualities to look for: must be attentive to strict deadlines and able to work with set deadlines accurately and timely
- Top 3 must-have hard skills stack-ranked by importance
1
Data Entry
2
Customer Service
3
Outlook and Excel experience
Candidate Review & Selection
- Shortlisting process
- Candidate review & selection
- Interview information
- Onboard process and expectations
Projected Manager Candidate Review Date:
1-2 days post shortlisting
Type of Interviews:
Teams, phones
Required Testing or Assessment (by Vendor):
Next Steps
