Credentialing Assistant

Credentialing Assistant

Remote Kentucky

Remote Ohio

Remote Indiana

Full time

R-379506

Become a part of our caring community and help us put health first

The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment.

The Credentialing Assistant 3 works in a production driven environment with some outreach to providers via phone. The Credentialing Department reviews and verifies providers’ credentials and qualifications to be in network. 

The department initially credential providers upon joining the network and then recredentials them every 3 years.  We ensure Humana’s policy remains in line with NCQA, URAC, and state requirements to maintain accreditation.  As a Credentialing Assistant 3 you will play a large role in initial credentialing and recredentialing of our providers.

Typical responsibilities, but not limited to:

• Performs initial credentialing via APEX
• Performs recredentialing via APEX
• Corrects errors as identified by leadership via APEX
• Outreaches to the provider/facility as needed to obtain missing/expired info
• Manages their own time to accomplish all necessary task on time
• Big picture - They will help drive the timely credentialing and recredentialing initiatives needed to maintain Humana’s network
• Use your skills to make an impact

Use your skills to make an impact

Required Qualifications

• 1+ years of administrative, support, data entry, or related professional experience
• 1+ years’ experience in a metric/production driven environment
• Prior professional experience using Microsoft Office Programs, including Word, PowerPoint, and Excel
• Demonstrated ability to articulate ideas effectively in both written and oral forms

Preferred Qualifications

• Associate's or Bachelor's Degree in Business, Finance or a related field
• Healthcare experience
• Credentialing, Contract Load, Service Fund, Directories or CIS experience
• Provider Network Operations or National Network Operations Experience
• Familiarity with medical terminology
• Additional Information

Additional Information

Work Hours:  Start between 7 a.m. - 9 a.m. and work M-F, 8-hour days

Interviewing Technology:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work At Home / Internet Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

Satellite, cellular and microwave connection can be used only if approved by leadership.

Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$43,000 - $56,200 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.

Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.