Credentials Examiner I (Remote, $16/hour)
Company: American Specialty Health Incorporated
Location: San Diego
Posted on: May 3, 2025
Job Description:
Description
American Specialty Health Incorporated is seeking a Credentials
Examiner I to join our Practitioner Contract Administration team.
This position will expedite credentials verification of
practitioners in the credentialing or recredentialing process
according to department standards, accreditation standards,
regulatory requirements, and health plan expectations.Remote Worker
ConsiderationsCandidates who are selected for this position will be
trained remotely and must be able to work from home (WFH) in a
designated work area with company-provided technology equipment.
This remote/WFH position requires you have a stable connection to
your Internet Service Provider with the ability to participate by
video in online meetings over a reliable and consistent network
(minimum internet download of 50 Mbps and 50 Mbps upload speed).
Responsibilities
Responsible to obtain information to
credential new applicants and recredential participating
practitioners according to department standards.Obtain required
documentation by mail, fax, or phone and update practitioner
files.Communicate with practitioners by mail, fax, or phone to
answer questions and obtain information in a timely manner.Respond
to provider inquiries within 48 hours of receipt via phone and/or
email communication.Communicate with management any barriers for
further support.Must successfully close a combined minimum number
of 200 Rehabilitative files and 150 Specialty Credentialing files
as set by department manager and subject to change based on
business need.Must successfully close a minimum number of 200
Re-Credentialing files as set by department manager and subject to
change based on business need.Ensure terminations and resignation
requests are sent by set timeline established by department manager
and can be subject to change based on business need.Enter data and
perform research functions in Promis/PCT/SharePoint/ASHCore to
complete each portion of the credentialing process within
predetermined timelines.Must complete regulatory trainings within
the timeframe provided by department manager.Perform all duties
necessary in handling the credentialing and recredentialing process
within predetermined timelines and state regulatory
standards.Quality Assurance measures should maintain accuracy rate
of no less than 99%.Abide by departmental work from home
expectations.Abide by Attendance & Punctuality policy and
department expectation.Qualifications
High School diploma required.Typing
speed must be between 45-50 wpm.Proficient in MS Office, including
experience with Excel.Core Competencies
Demonstrated ability to interact in a
positive, respectful manner and establish and maintain cooperative
working relationships.Ability to display excellent customer service
to meet the needs and expectations of both internal and external
customers.Excellent listening and interpersonal communication
skills to identify critical core competencies based on success
factors and organizational environment.Ability to effectively
organize, prioritize, multi-task and manage time.Demonstrated
accuracy and productivity in a changing environment with constant
interruptions.Demonstrated ability to analyze information,
problems, issues, situations and procedures to develop effective
solutions.Ability to exercise strict confidentiality in all
matters.MobilityPrimarily sedentary, able to sit for long periods
of time.Physical RequirementsAbility to speak, see and hear other
personnel and/or objects. Ability to communicate both in verbal and
written form. Ability to travel within the facility or work from
home. Capable of using a telephone and computer keyboard. Ability
to lift up to 10 lbs.Environmental ConditionsWork-from-home (WFH)
environment.American Specialty Health is an Equal
Opportunity/Affirmative Action Employer.All qualified applicants
will receive consideration for employment without regard to sex
(including pregnancy, childbirth, related medical conditions,
breastfeeding, and reproductive health decision-making), gender,
gender identity, gender expression, race, color, religion
(including religious dress and grooming practices), creed, national
origin, citizenship, ancestry, physical or mental disability,
legally-protected medical condition, marital status, age, sexual
orientation, genetic information, military or veteran status,
political affiliation, or any other basis protected by applicable
local, federal or state law.Please view Equal Employment
Opportunity Posters provided by OFCCP .If you are a qualified
individual with a disability or a disabled veteran, you have the
right to request an accommodation if you are unable or limited in
your ability to use or access our career center as a result of your
disability. To request an accommodation, contact our Human
Resources Department at (800) 848-3555 x6702.ASH will not discharge
or in any other manner discriminate against employees or applicants
because they have inquired about, discussed, or disclosed their own
pay or the pay of another employee or applicant. However, employees
who have access to the compensation information of other employees
or applicants as a part of their essential job functions cannot
disclose the pay of other employees or applicants to individuals
who do not otherwise have access to compensation information,
unless the disclosure is (a) in response to a formal complaint or
charge, (b) in furtherance of an investigation, proceeding,
hearing, or action, including an investigation conducted by the
employer, or (c) consistent with the Company's legal duty to
furnish information.#LI-Remote
Keywords: American Specialty Health Incorporated, Calexico , Credentials Examiner I (Remote, $16/hour), Other , San Diego, California
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