Navigating and analyze credentialing data
Understanding and completing CMS Surveys and other documents for Organizational Providers
CAQH Intiatives
Evaluating and investigating practitioner and facility state licenses for actions, sanctions and/or malpractice claims history to process accordingly with summaries created in electronic file for presentations
Analyzing files to ensure compliance with recredentialing timelines and collaborate with Sr. Analysts to ensure alignment with the national CAQH VeriFide initiatives
Performing board certification and eligibility analysis and compare to rural health practitioner Excel spreadsheet to determine certification exception eligibility
Qualifications:
Associates Degree
2-5+ years work experience in contracts or provider enrollment
Knowledge in NCQA, DIFS, and CMS
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