Credentialing Analyst

Reviews the approval and termination of professional provider contracts.

Ensure accurate and timely information for the purposes of re-credentialing, data analysis, and directory generation.

Recommend changes to the credentialing criteria and processes.

Maintains all the credentialing and re-credentialing policies and processes to ensure that they are in compliance with all applicable regulations.

Develops and implements departmental goals and objectives with input from staff members.

Develops and implements departmental policies and procedures that guide and support the provision of services.

Interacts with all customers to ensure prompt and accurate communication as needed to provide service expected and to meet the goals of service.

Evaluate problems and develops and implement solutions.

Supports, encourages, and contributes to the professional growth of all department employees.

Responsible for the continuous assessment and improvement of the quality of care and services provided.

Adheres to all compliance & integrity program rules and requirements. Manage all new client account setups, research and development activities.

Manage VAS, provider enrollment, claims submission, and various other projects for the NASD department.

Train and guide team members on new challenges in the healthcare industry along with keeping a close coordination with providers (clients).