Credentialing Assistant 3 English/Spanish San Juan PR

Profile

Description

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. May apply intermediate mathematical skills.

Responsibilities

The Credentialing Assistant 3 reviews the applicant's education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Reviews the information and documentation collected, as well as verification that the information is accurate and complete. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.

Required Qualifications

Bachelor's Degree in Business, Finance or a related field (or equivalent job experience)

Proficiency in all Microsoft Office applications, including Word and Excel

Excellent communication skills, both verbal and written

Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Bilingual English/Spanish. (Intermediate/Advance English level) Candidate selected will not be communication in English with members.

Preferred Qualifications

Credentialing and Re-credentialing experience

Familiarity with medical terminology and/or ICD-10 codes

Additional information

Schedule: Monday to Friday from 8 am to 5 pm, Overtime, needed to work some weekends

Training: 3 weeks - Virtual

Work Location (Address): Due to COVID-19 emergency, this position is temporary working from home. When emergency is lifted, associates will be working from an office located at: 383 FD ROOSEVELT AVE. SAN JUAN, PR 00918

For positions that are temporarily working at home due to COVID.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.

For in-office positions - Restriction IF any recent international travel.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. You may need a personal computing device with a camera and internet connection for interview purposes. This position will also be subject to restrictions for recent international travel. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com