Credentialing Administrative Assistant
Community & Nonprofit
Position Description / Responsibilities
Summary of Job: Complying with all credentialing standards of NCQA for all direct care licensed/non-licensed providers as required by the state, managed care companies, and/or third party payers.
Essential Duties and Responsibilities:
1) Prepares and submits accurate credentialing/re-credentialing applications for appropriate licensed providers, including maintaining and updating the credentialing files in a timely fashion based on NCQA standards;
2) Prepares credentialing documents and assists Credentialing Specialist in leading credentialing committee for all delegated credentialing contracts;
3) Mails 5-day letters for all pending credentialing, re-credentialing and subcontracted files;
4) Prepare credentialing, re-credentialing and subcontracted files at least one business day prior to credentialing meeting;
5) Prepare credentialing minutes and distribute CRC approval/denial letters within 5 days of CRC meeting;
6) Process information on credentialed staff following each CRC meeting;
7) Update SSOC and Licensed Providers spreadsheets after each credentialing meeting;
8) Pull termed files and scan into Credential Scans share drive;
9) Maintain and update spreadsheets on Credential Tracking share drive daily, or as information is received from staff and hiring managers;
10) Filing and other duties as assigned by Credentialing Specialist
Job Qualifications: High school diploma or GED required. Three to five years administrative experience preferred.
Centerstone is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, among other things, or status as a qualified individual with disability.