Credentialing Specialist

4 weeks ago


Philadelphia, Pennsylvania, United States Independence Blue Cross Full time
Credentialing Intake Specialist Role

At Independence Blue Cross, we're seeking a skilled Credentialing Intake Specialist to join our team. In this role, you'll play a critical part in ensuring the accuracy and completeness of credentialing applications. Your attention to detail and analytical skills will be essential in determining whether credentialing criteria are met and compliant with corporate, state, federal, and accreditation requirements.

Key Responsibilities:
  • Conduct primary source verifications of practitioner credentials as required by corporate, state, federal, and accreditation standards.
  • Utilize approved verification sources to ensure accuracy and efficiency.
  • Support decisions and verifications with appropriate documentation and rationale in the practitioner's electronic record.
  • Manage daily workflow by running reports from the credentialing database to meet accreditation and/or corporate requirements and timeframes.
  • Perform other assigned duties as needed to support the credentialing department.

Requirements:
  • Bachelor's degree in a related field or equivalent experience with a minimum of two years in credentialing, quality assurance, or auditing.
  • Excellent research, analytical, and decision-making skills.
  • Demonstrated organizational ability with attention to detail.
  • Excellent communication skills, both verbal and written, with the ability to compose professional correspondence.
  • Demonstrated phone skills and proficiency in using a computer.

Work Environment:
This role is part of our Hybrid model, which consists of working in the office three days a week and remotely two days a week. While working remotely, you must be located in the Tri-State Area of Delaware, New Jersey, or Pennsylvania. Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer, and we welcome qualified applicants from diverse backgrounds. Must have an Android or iOS device compatible with the free Microsoft Authenticator app.

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