Credentialing Professional - Miami

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Job Information
Humana
Credentialing Professional - Miami
in
Miami
Florida
Description
The Credentialing Professional 1 obtains and reviews documentation to determine status in a health plan. The Credentialing Professional 1 work assignments are often straightforward and of moderate complexity.
Responsibilities
About Us
Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. In the Primary Care Organization, a division of Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. We're seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.
The Role
The Credentialing Professional 1 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. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/ regulations/professional standards with some interpretation.
Vaccine Policy
For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination, including booster or commit to testing protocols
OR  
Provide proof of applicable exemption including any required supporting documentation
​​Medical, religious, state and remote-only work exemptions are available.
Required Qualifications
Associate's degree or related experience
A minimum of two years of credentialing experience in healthcare
Ability to learn credentialing software; ability to complete reporting
Ability to prioritize workload to ensure deadlines are met
Excellent written and oral communication skills required.
Excellent PC skills (including MS Word, Excel and Access) required.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Bachelor's degree in Business, Health Administration, Accounting or related field required.
Bilingual; English & Spanish
Experience in managed care or health care administration desired.
Additional Information
Incumbent must reside in the Miami area
Role will be remote initially; and will later transition to a hybrid office workstyle
Scheduled Weekly Hours
40

Company info

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