Job Description
Credentialing providers, ensuring application data is correct and accurately submitted to committee within turnaround time. Timely communication with providers via phone calls, emails and faxes. Achieving all metrics/expectations. Assisting team members with questions - as available. Attending all team huddles, 1:1 and barrier check-ins.
The successful candidate will be responsible for all aspects of the credentialing and re-credentialing processes. The Coordinator will assess risk and perform sanctions monitoring to ensure compliance with Cigna's policies, NCQA, and standards for Medical, Behavioral and Dental businesses.
Responsibilities:
- Reviews credentialing and re-credentialing files to determine risk and prepare summaries of all risk files requiring National Credentialing Committee Review.
- Reviews all newly identified sanctions and prepares summaries of all sanctions requiring National Credentialing Committee review.
Ensures documentation is prepared in time for committee packet mailing deadline. - Ensure timely and professional communication with internal/external customers as needed to expedite timely resolution via phone, email, and fax.
- Correct any elements listed on the errors/quality reports as well as any other identified reports.
- Consistently performs to department accuracy and quality audit standard results while maintaining timeliness measures.
- Balance priorities and daily responsibilities and notify supervisor of any barriers.
- Completes assigned projects and corporate training within agreed upon time frames.
Qualifications:
- Associate's degree or higher strongly preferred or equivalent work experience required
- 1+ years of credentialing experience required
- Excellent technical, computer, and software skills specifically with Microsoft Office (Word, Excel, Outlook) highly preferred
- Experience with Adobe highly preferred
- Experience with Salesforce highly preferred
- Ability to work in fast paced, quick changing environment
- Professional organizational behavior
- Excellent time management and organizational skills
- Proficient in critical thinking and problem solving
- Strong attention to detail and quality results
- Deadline oriented and accountable for production
- Proficient in oral and written communication skills
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 21 - 31 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Job Tags
Hourly pay, Permanent employment, Work experience placement, Work at office, Local area, Remote work, Work from home,