Credentialing Auditor in Latham, NY at Beacon Health Options

Date Posted: 2/15/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamicCredentialing Auditor to join our growing team in Latham, NY to perform quality oversight of out Credentialing Specialists.

Position Responsibilities:

  • Performs quality oversight of the Credentialing Specialist by conducting random provider file audits, following department workflow and established random sampling procedure. 
  • Maintain expert and complete knowledge of the processes involved in entering data into the internal tracking system
  • Track and identify trends to recommend remedial action and/or changes in the established procedures.
  • Exhibits professional oral and written communication skills. 
  • Maintains strict confidentiality of all job related information by ensuring the information is shared with appropriate parties.
  • Assist with workflow development and/or implementation and other quality related activities.
  • Ability to deal with complex issues while maintaining a flexible positive, cooperative demeanor.  Flexibility and adaptability to meet periodic changes in departmental needs.  Promotes direct, honest, open and timely communication.
  • Ability to work in a fast paced environment and prioritize multiple demands. Demonstrate exceptional organizational skills, capable of prioritizing responsibilities, multi task, detail oriented, and ability to work independently with limited supervision.
  • Ability to learn quickly and a keen eye for details, analytical and problem solving skills, the ability to withstand varying job pressures and to meet deadlines.
  • Ability to work in a production based environment and meet production goals. Incumbent must maintain minimum number of files reviewed on a daily basis as well as an industry standard refute overturn rate
  • Must understand the principles of Quality Improvement and demonstrate commitment to compliance and continuous improvement.
  • Displays flexibility in work assignments and a positive attitude.

Position Requirements:

  • Education:  High School diploma or equivalent required
  • Relevant Work Experience:   3 years working experience in the health insurance industry.
    • 6 months experience in credentialing preferred.
  • Knowledge, Skills and Abilities:
    • Excellent written and oral communication skills.
    • Excellent customer service skill
    • Excellent organizational and presentation skills
    • Proficient in Microsoft Word, Excel, and Access

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position.

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled​.

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