Credentialing Specialist- Work from home for (AK, AZ, ID, FL, OR, TX, or WA) ?? Portland, OR in Portland, OR in Moda Health

Job title: Credentialing Specialist- Work from home for (AK, AZ, ID, FL, OR, TX, or WA) - Portland, OR

Company: Moda Health

Job description: Let's do great things, together Founded in Oregon in 1955, ODS, now Moda, is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

Performs all verification activities associated with credentialing and re-credentialing Moda contracted providers in accordance with Moda policies, National Committee for Quality Assurance (NCQA) standards and state and federal requirements.

????This is a Work From Home PST position. We are only offering this position to candidates living in or willing to relocate to AK, AZ, ID, FL, OR, TX, or WA.

Please follow the link below to apply to this position:

Benefits:
?? Medical, Dental, Vision, Pharmacy, Life, & Disability
?? 401K- Matching
?? FSA
?? Employee Assistance Program
?? PTO and Company Paid Holidays

Schedule:
?? PST
?? Monday - Friday

Requirements: * Type a minimum of 50 wpm on computer keyboard and Ten key proficiency of 135 kspm net. ?? Strong organizational and time management skills. ?? Ability to meet deadlines, maintain confidentiality, produce work high volumes, work independently as well as in a diverse team environment. ?? Ability to problem solve, retain information and have strong attention to detail. ?? Working knowledge of NCQA, the Centers for Medicare and Medicaid Services and Oregon Health Authority or other state credentialing standards helpful. ?? Excellent verbal, written and interpersonal skills.

Primary Functions: * Verifies the credentials timely and accurately, through approved sources of providers on the Moda panel.
?? Monitors requests for and receipt of credentialing and re-credentialing applications.
?? Completes all documentation and data entry information into the credentialing database.
?? Identifies and reports any non-compliance or credentialing issues to the credentialing supervisor.
?? Communicates with providers directly or with appropriate office staff regarding the Moda credentialing process, submitted application status and required documentation requests.
?? Updates database with current provider demographics.
?? Manages provider data within the credentialing database from delegated entities.
?? Assures confidentiality of documents, records and data information. Keeps all documents secure and confidential.
?? Performs other duties as assigned.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our [email protected] email.

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Pay Range

$20.07 Hourly to $23.03 Hourly

Expected salary: $20.07 - 23.03 per hour

Location: Portland, OR

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