Become a part of our caring community and help us put health first
 

As a customer-centric company, our top priority has always been the health of the people we serve. Our decades of experience helping millions of members, and our continuous learning on how to meet their evolving needs, fuels our purpose and our passion for serving our customers.

Credentialing Operations bonds the trust between patient and provider. Come join our organization and assist us in ensuring we continue to be a top choice for our members.

The Credentialing Department reviews and verifies providers’ credentials and qualifications to be in network.  The department initially credential providers upon joining the network and then recredentials them every 3 years.  We  ensure Humana’s policy remains in line with NCQA, URAC, and state requirements to maintain accreditation.  As a Credentialing Assistant 3 you will play a large role in initial credentialing and recredentialing of our providers.  This is a production driven environment with some outreach to providers via phone.

Typical responsibilities, but not limited to:

•        Performs initial credentialing via APEX

•        Performs recredentialing via APEX

•        Corrects errors as identified by leadership via APEX

•        Outreaches to the provider/facility as needed to obtain missing/expired info

•        Manages their own time to accomplish all necessary task on time

•        Big picture - They will help credentialing/recredentialing of State Medicaid Market

Use your skills to make an impact
 

Required Qualifications

• 1+ years of administrative, support, data entry, or related professional experience.
• 1+ years experience in a metric/production driven environment
• Prior professional experience using Microsoft Office Programs, including Word, PowerPoint, Excel.
• Must meet Humana's Work at Home connectivity requirements listed in additional information

Preferred Qualifications

• Associate's or Bachelor's Degree in Business, Finance or a related field

• Health Care experience

• Credentialing, Contract Load, Service Fund, Directories or CIS experience

• Provider Network Operations or National Network Operations Experience

• Familiarity with medical terminology and/or ICD-10 codes

Additional Information

Hours:  7a-9am start time

Training: 7:30am-4pm

Location: Remote (within the states listed on posting)

Virtual Pre-Screen

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work at Home Connectivity Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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 connection can be used only if approved by leadership
Employees 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 employees 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

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

If you have additional questions regarding this role posting, please send them to the Ask A Recruiter by visiting go/Buzz