Anthem, Inc. Credentialing Specialist Senior in Washington, District Of Columbia
SHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
The Credentialing Specialist Sr ensures the integrity of credentialing data and provides expertise and guidance to other credentialing associates.
Primary duties may include, but are not limited to:
Audits work of other credentialing associates.
Compiles and reviews documentation required by credentialing committee.
Responds to the most complex provider credentialing, compliance and accreditation issues.
Researches pended and probated applications and resolves discrepancies.
Monitors reports identifying practitioners on sanctions or those who do not meet credentialing criteria for further action and assists in researching related issues.
May assist in delegation oversight and identifies on-going training needs.
Assists in developing training materials.
Requires a H.S. Diploma ; 4-5 years credentialing experience; or any combination of education and experience, which would provide an equivalent background.
CPCS or CMSC preferred.
Knowledge/proficiency using Cactus is a plus
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.