Job ID: J133232
Company: Gateway Health Plan
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Oct 11, 2018
Processes provider applications and re-applications including initial mailing, review, and loading. Maintains provider data base and communicates with providers by phone and mail regarding credentialing status and information. Performs credentialing, re-credentialing and related activities and coordinates credentialing verifications. Reviews and processes more complex additions, updates and deletions of provider information in the Dental Provider file database. Supports the implementation of new networks, systems, software, guidelines and other endeavors with a focus on “group practices” as opposed to individual providers.
Depending on level, trains credentialing personnel in the use of various systems, software, databases and procedures. Participates in projects which streamline, automate or otherwise enhance credentialing functions.
1. Credentials and re-credential providers
2. Support projects, audits, business partners, internal departments and external clients
3. Lead Team (dependent on level)
4. Other duties as assigned or requested.
Education, Licenses/Certifications, and Experience
Knowledge, Skills and Abilities
SCOPE OF RESPONSIBILITY
Does this role supervise/manage other employees?
Is Travel Required?
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org