Core: Working knowledge of NCQA standards and payer credentialing standards.
Knowledge of vision, dental or hearing industry.
Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing.
Integrity & responsibility: acting with a clear sense of ownership for actions, decisions and to keep information confidential when required.
Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties. Minimum
Qualifications: Associate degree or equivalent combination of education and experience.
As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue.
Qualifications: CPCS certified Equal Employment Opportunity At Avēsis, We See You.
experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avēsis, where We See You!
Experience
Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient. 3 years credentialing experience, preferably in a managed care setting. Preferred
Benefits
Join us for an exciting career with the leading provider of supplemental benefits! O ur Promise Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. In this role, you’ll be the gatekeeper for ensuring our healthcare partners meet regulatory
Come Dare to be Different at Avēsis, where We See You! At Avēsis, we strive to design equitable, and competitive compensation programs.
Base pay within the range is ultimately determined by a candidate's skills, expertise, or experience.
In the United States, we have three geographic pay zones.
For this role, our current pay ranges for new hires in each zone are: Zone A: $16.68-$27.81 Zone B: $18.14-$30.24 Zone C: $19.55-$32.59 FLSA Status: Hourly/Non-Exempt This role may also be eligible for benefits, bonuses, and commission.
Please visit Avesis Pay Zones for more information on which locations are included in each of our geographic pay zones.
Competitive compensation package.
Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
Life and disability insurance.
A great 401(k) with company match.
Tuition assistance, paid parental leave and backup family care.
Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
We also would never ask applicants for personal information, such as passport numbers, bank account numbers, or social security numbers, during our process.
Equal Employment Opportunity At Avēsis, We See You.
Contact
Any emails from Avēsis recruiters will come from a verified email address ending in @ Avēsiscom.
If you are unsure of the legitimacy of a communication you have received, please reach out to ITsupport@Avesis.com .
To learn more about protecting yourself from fraudulent activity, please refer to this article link ( https://consumer.ftc.gov/articles/how-avoid-scam ).
If you believe you were a victim of fraudulent activity, please contact your local authorities or file a complaint (Link: https://reportfraud.ftc.gov/#/ ) with the Federal Trade Commission.
Additional details
requirements and industry best practices, directly impacting the quality of care delivered to patients.
You’ll work closely with cross-functional teams to ensure provider data is accurate, up-to-date, and compliant.
Your work helps shape a trusted network of healthcare providers, ensuring patients receive care from credentialed and qualified professionals. Functional: Facilitate provider onboarding efforts including, but not limited to importing data from CVO into applicable systems, ensuring required documentation is complete and accurate, ensure all submitted documentation aligns with industry and organizational standards.
Performs timely follow-up with providers on pending applications/information Perform primary source verifications according to the departmental policies and NCAQ standards when not completed by CVO.
Builds and accurately maintains provider information in various systems Responds to inquiries regarding the status of provider’s application Utilizes organizational templates to communicate with providers about the status of their application with the organization Provides support to Credentialing Specialist I on functional responsibilities.
Behavioral: Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth.
Initiative: readiness to lead or take action to achieve goals.
Member-focused: going above and beyond to make our members feel seen, valued, and appreciated.
Detail-oriented and thorough: managing and completing details of assignments without too much oversight.
Flexible and responsive: managing new demands, changes, and situations.