- Oversees the entire credentialing process, ensuring its efficiency, accuracy, and compliance with industry and organization standards/requirements.
- Performs trainings and educates stakeholders and/or interested parties in the credentialing process.
- Reviews and verifies all contracts for completeness.
- Corresponds with outside agencies through various channels, email, phone, etc.
- Analyzes and submits weekly reports for management staff.
- Handles complex issues related to provider credentialing.
- Ensures adherence with applicable federal and/or state laws, regulations, and/or agency rules, contract standards and guidelines, etc.
- Establishes good working relationship with fellow employees, transportation providers, and other stakeholders.
- Ensures accurate and timely data inputs and reviews.
- Proactively partners across all departments to manage the timely satisfaction of Modivcare's obligations under all contract agreements.
- Makes recommendation for process improvements to management / Credentialing Services team.
- Maintains a comprehensive understanding of relevant industry regulations, accreditation standards, and maintains a working knowledge of company operations and procedures.
- Mentors credentialing staff by sharing knowledge and best practices.
- May lead projects and perform other duties as assigned.
- High School Diploma required.
- Four (4) plus years of experience in Credentialing Services or similar role.
- Or equivalent combination of education and/or experience.
- Deep understanding of credentialing processes, industry standards, and regulatory requirements.
- Strong analytical and problem-solving skills with a precise eye for detail.
- Clear and effective verbal and written communication skills.
- Strong organization skills and superior time-management skills.
- Proficiency in Microsoft products (Work, Outlook, Excel).
- Understand the importance to maintain confidentiality and handle sensitive information.
- Experience with specialized software and databases to manage and track credentials is a plus.
We value our team members and realize the importance of benefits for you and your family.
- Medical, Dental, and Vision insurance
- Employer Paid Basic Life Insurance and AD&D
- Voluntary Life Insurance (Employee/Spouse/Child)
- Health Care and Dependent Care Flexible Spending Accounts Pre-Tax and Post
- -Tax Commuter and Parking Benefits
- 401(k) Retirement Savings Plan with Company Match
- Paid Time Off
- Paid Parental Leave
- Short-Term and Long-Term Disability
- Tuition Reimbursement
- Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)
- EEO is The Law - click here for more information
- Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
- We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at hr.recruiting@modivcare.com