paycor
Credentialing Assistant
Provider Partners Health Plan
Remote, USA
Full-time
Entry · 0+ years experience
Remote
Discovered 1 weeks ago
SalesforceCAQHMicrosoft OutlookMicrosoft Excel
Free
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SalesforceCAQHMicrosoft Outlook
Key Skills for This Role
SalesforceCAQHMicrosoft OutlookMicrosoft Excel
Full Job Posting
- Monitor credentialing email activity each workday, including morning and afternoon review.
- Respond to all credentialing emails within 24 hours.
- Send credentialing-related email communications through Salesforce in accordance with department procedure.
- Escalate urgent or unresolved matters to the Credentialing Coordinator or Manager, as appropriate.
- Maintain clear and timely documentation of communications and follow-up activity in Salesforce.
- Initiate facility recredentialing outreach according to the established SOP timeline:
- 90 days before the recredentialing due date: send the initial outreach email.
- 60 days before the due date: send the follow-up outreach email.
- 45 days before the due date: make the final outreach attempt by telephone.
- Document all outreach and follow-up activity in Salesforce.
- For facility recredentialing that remains incomplete after required outreach, update the provider status in Salesforce to 'F/U by PR' in accordance with the SOP.
- Review facility recredentialing applications and submitted documents upon receipt.
- Screen all submitted materials for completeness before routing the file for credentialing processing.
- When all required documents are present, notify the Credentialing Coordinators that the application is complete and ready for processing.
- Maintain accurate documentation in Salesforce to support workflow visibility and handoff.
- Process and complete all provider termination requests within three (3) business days of receipt.
- Run applicable Salesforce reports required to support termination activity.
- Remove providers from CAQH when required by the termination workflow.
- Remove the applicable provider association or location from Salesforce in accordance with established procedures.
- Update Salesforce to accurately reflect completed termination activity, including required status changes and documentation.
- Track termination requests from receipt through completion to ensure compliance with the three-business-day turnaround standard.
- Escalate any termination request that cannot be completed within three business days to the Credentialing Manager, including the reason for delay and outstanding action required.
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