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Job description
Description
When it comes to making a meaningful difference in the lives of our customers and employees, USAble Life is always ready. We are a diverse group of individuals working together to go the extra mile. Through our DEI initiatives, employees feel empowered to bring their talents and voice to our culture.
Our passion for delivering the best products is matched only by our passion for our people. We are committed to making a meaningful difference in the lives of others which extends beyond our office walls. USAble Life has a long tradition of supporting our communities, and we're proud of the fact that our employees share that commitment.
We have been recognized as a "Best Places to Work" in Arkansas, Florida, and Hawaii. You'll be rewarded with opportunities for personal and professional development and opportunities for advancement. This, coupled with our engaging culture and a comprehensive benefits package, ensures we are committed to our employees.
Check out how we make a meaningful difference in the lives of others!
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What We Offer You:
A culture that values employees and celebrates, empowers, and inspires a diverse workforce
Outstanding and affordable benefits package
PTO provided at date of hire
11 paid holidays
401(k) with up to 6% match; fully vested from day 1
Remote opportunities with company-provided equipment
Team-oriented, collaborative group of peers
Career advancement opportunities
Tuition Reimbursement
Employee Assistance Program
Inclusion Council and Employee Resource Groups
Recharge Days and Volunteer Time Off
Pay Transparency: Our salary ranges are structured to provide opportunities for growth and advancement within a role. As a result, most new hires are placed between the minimum and midpoint of the range based on qualifications and experience, while the top of the range is generally reserved for employees who have demonstrated sustained expertise and performance in the position. The anticipated pay for new hires entering as a Provider Data Maintenance & Credentialing Specialist I is between $41,900 to $48,200. Pay is based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications, and company tenure & equity. In addition to base compensation, this role is eligible for an annual incentive plan based on company performance and individual performance.
Provider Data Maintenance & Credentialing Specialist I Overview
*This position is primarily remote role with onsite presence required for a single day every few weeks.*
Conducts provider credentialing application and contract package review prior to processing. Performs timely data entry of provider application information and contract arrangements into administrative system. Prepares adverse files for review by the Dental Credentialing Committee. Updates and maintains contract and demographic information on participating providers. Generates correspondence to providers confirming contract or demographic changes, credentialing status, and requests for missing or incomplete information. Provides general assistance with projects as required.
Essential Duties:
Enters credentialing and re-credentialing applications into the administration systems.
Conducts follow-up as necessary with Credentialing Verification Organization to obtain completed Primary Source Verification credentialing report in a timely manner.
Communicates with providers regarding missing information from credentialing files and requests additional information from external agencies.
Reviews credentialing reports loaded into the administration system for accuracy
Performs timely data entry of contract arrangements into administration system following credentialing.
Updates and maintains contract and demographic changes ensuring accurate reporting, claims payment and directory information.
Ensures timely follow-up is conducted to secure missing information.
Generates letters to providers following contract or demographic maintenance.
Meets or exceed departmental and individual metrics goal expectations as required by productivity and quality. Prepares documents for contract execution
Processes adverse files including researching information with appropriate agencies.
Prepares adverse reports for review by the Dental Credentialing Committee.
Performs telephonic and written correspondence outreach to providers for any missing, expired or incomplete documentation.
Performs other related duties and responsibilities as assigned
Required Knowledge, Skills, and Abilities:
Experience in the health or dental insurance industry
Excellent communication skills including the ability to address a wide range of audiences
Customer service skills
Basic MS Office skills
Ability to read documents and extract information
Ability to understand and evaluate contractual language
Ability to work within time constraints and maintain attention to detail
Ability to prioritize workflow and work independently but coordinate efforts within a team
Required Education and Experience:
High school diploma or equivalent
2 - 4 years of related experience
Or, equivalent military experience
Preferred Education and Experience:
Associate's Degree with 3 years of related experience
Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment visa at this time
#USAL1
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.