Credentialing Analyst - Healthcare

Hospital Services Corporation provides credentialing services for various hospitals nationwide. We are growing and recruiting a Credentialing Analyst who is responsible for analyzing and processing documents for credentialing and licensing of healthcare providers with emphasis on customer support, processing accuracy and timeliness of all services provided to customers. Responsibilities include:

• Utilizing the eCreds database in the processing of customer organizations’ licensing or credentials files. Enter customer organizations’ credentials data into the database as accurately and timely as possible.
• Assist with pre-processing of licensing files to meet state licensing requirements.
• Process primary source verifications of medical education, board certification, licensure, drug registration, and any other information necessary to complete a state licensing or credentials file for providers of customer organizations using the program’s database whenever possible.
• Establish customer organizations’ new licensing or appointment files upon receipt of customer request forms and processes and maintain the files in an orderly and neat manner.
• Follow up with customers, providers and third parties to obtain needed information using phone and email as appropriate to ensure items are obtained in a timely manner.
• Query the appropriate resources for information pertaining to adverse actions on licensure for customer organizations’ medical staff members/providers.
• Analyze credentialing files to ensure regulatory and customer requirements are consistently met.
• Meet daily productivity standards and monthly department metrics. Achieve other goals as determined during the performance planning process.
• Works closely with other Credentialing Analysts and Assistant Analysts to ensure all credentialing, re-credentialing, and file maintenance files for all customer organizations’ providers are completed in a quality manner and completed timely.
• Maintain various reports for distribution to appropriate internal and external customers. Such reports include, but are not limited to, check and credit card fees, monthly billing reports, updated provider reports, file maintenance reports, licensure expiration reports, and credentialing status reports.
• Keep abreast of all standards and regulations pertaining to the state licensing or credentialing process such as Joint Commission and NCQA.
• Provide excellent customer service support by handle Customer Service calls, as received through the call rotation system and submit AutoTask tickets as appropriate.
• Handle assigned AutoTask tickets in a timely manner and support the Customer Services desk, as necessary.
• Other duties as assigned by the Staff Readiness Manager.

**Job Qualifies for hybrid work schedules and flexible work weeks.

Job Type: Full-time

Pay: $21.00 - $27.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Supplemental pay types:

• Bonus opportunities

People with a criminal record are encouraged to apply

Experience:

• NCQA standards: 2 years (Preferred)
• Provider Credentialing: 3 years (Required)

Ability to Relocate:

• Albuquerque, NM 87109: Relocate before starting work (Required)

Work Location: Hybrid remote in Albuquerque, NM 87109