Sr Credentialing Specialist
Functions as a team lead in performing credentialing activities on behalf of all CommunityCare lines of business. Responsible for performing credentialing activities on behalf of all CommunityCare Managed Healthcare Plans of Oklahoma lines of business. Following procedures consistently for each applicant.
Credentialing is performed in accordance with federal and state mandates, and credentialing criteria as outlined in the CommunityCare Managed Healthcare Plans of Oklahoma Policy and Procedure Manual.
- High School Diploma or equivalency.
- Associates degree plus one year related healthcare/managed healthcare experience OR high school diploma plus five years of related experience. Bachelors degree preferred
- Two years credentialing experience in a managed care organization, hospital or physician environment required.
- CPMSM or CPCS certification preferred.
- Excellent oral and written communication skills.
- Ability to interpret and communicate information efficiently and effectively.
- Successful completion of Health Care Sanctions background check.
- Ability to work independently, handle multiple tasks and projects simultaneously and strong organizational ability.
- Ability to maintain a positive working environment, project a positive attitude, be a self starting individual and maintain a team player attitude.
- Ability to handle confidential information in a professional and sensitive manner.
- Ability to converse and write fluently in English.