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Credentialing Specialist II Job

Date: Feb 7, 2019

Location: Eagan, Minnesota, US, 55122

Company: Blue Cross and Blue Shield of Minnesota

 



About Blue Cross



 



Founded in 1933, Blue Cross and Blue Shield of Minnesota is the largest health plan in the state. We have more members, the largest network of providers and more products and services than any other plan in Minnesota. From the beginning, Blue Cross has been an innovator with a mission of making a healthy difference in people’s lives.



 



We understand the importance of finding a job that you truly enjoy — at a company that shares your values. We’ve made it easy to feel good about working at Blue Cross by encouraging volunteerism, valuing diversity and offering the flexibility you need to live a balanced life. We offer a suite of comprehensive medical and dental benefits as well as competitive pay, flexible work schedules and generous personal paid time off in addition to 20 hours of volunteer paid time off each year. We look forward to serving Minnesotans over the next 80 years and beyond. Join us and make a healthy difference through the work you do every day.


Description Summary

This position is responsible for activities associated with the credentialing process and completing the set-up and maintenance of practitioner and provider information on the provider databases. These activities will adhere to regulatory agency credentialing requirements, such as NCQA, Dept of Health, Medicare, TRIWEST and Blue Cross Blue Shield Association

Accountabilities


  1. Determine credentialing status by screening and assessing all credentialing materials. Research, analyze and process routine credentialing cases.

  2. Set up and maintain accurate provider and practitioner information on the provider databases, which are used for consumer initiatives with Blue Cross.

  3. Respond to customers regarding provider and practitioner eligibility and credentialing decisions and/or related issues.

  4. Maintain credentialing quality and production performance metrics.

  5. Contribute to process improvements to ensure an efficient operation.

  6. Special projects as assigned.


Requirements


  • High school diploma and 4 years customer service experience.

  • 1 year experience in the area of Provider Credentialing.

  • Ability to handle multiple tasks or projects.

  • Detail-oriented with a quality focus.

  • Ability to work independently and demonstrate problem-solving skills.


Preferred Requirements

FLSA Status

Non-Exempt

Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



 



Make a difference



 



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



 



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



 



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association


Nearest Major Market: Minneapolis

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