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TM-Provider Credentialing

00067976691



Job Summary

The TM-Provider Credentialing role requires a seasoned professional with 10 to 12 years of experience in provider credentialing processes. The candidate will leverage their expertise in Facets - Provider and domain skills in Primary Source Verification and Credentialing Application Processing to ensure compliance and efficiency. This position is based in the office and operates during night shifts requiring proficiency in English.


Responsibilities

  • Oversee the credentialing process to ensure all providers meet necessary qualifications and standards.
  • Coordinate with various departments to streamline credentialing application processing.
  • Implement best practices in Primary Source Verification to maintain high standards of accuracy.
  • Utilize Facets
  • Provider to manage and track credentialing data efficiently.
  • Ensure compliance with regulatory requirements and industry standards.
  • Provide detailed reports on credentialing status and progress to management.
  • Collaborate with providers to resolve any credentialing issues or discrepancies.
  • Develop and maintain documentation related to credentialing processes.
  • Conduct audits to verify the accuracy and completeness of credentialing records.
  • Train team members on credentialing procedures and system usage.
  • Monitor industry trends to anticipate changes in credentialing requirements.
  • Facilitate communication between providers and the organization to ensure smooth credentialing operations.
  • Enhance the credentialing process to improve efficiency and reduce turnaround time.

    • Qualifications

  • Possess strong expertise in Facets
  • Provider to manage credentialing data.
  • Demonstrate proficiency in Primary Source Verification to ensure accuracy.
  • Exhibit comprehensive knowledge of Credentialing Application Processing.
  • Have excellent communication skills in English for effective collaboration.
  • Show ability to work efficiently during night shifts in an office setting.
  • Display attention to detail and problem-solving skills in credentialing tasks.
  • Maintain up-to-date knowledge of industry standards and regulatory requirements.

    • Certifications Required

    Certified Provider Credentialing Specialist (CPCS) or equivalent certification relevant to credentialing processes.

    What we offer

    • The chance to work with impact. Here, you’re empowered to bring your biggest thinking to help our company and clients improve everyday life.
    • Ownership over your career. Stay at the top of your game through our award-winning learning and development ecosystem. And when your ambitions change or we offer new opportunities, we help you pivot by providing reskilling, on-the-job learning and guidance to find new roles that might be a better fit.
    • The opportunity to thrive on a high caliber team with heart. We celebrate each other’s experiences and perspectives and promote a sense of belonging through our affinity groups and diversity and inclusion initiatives.
    • A comprehensive total rewards package, including a competitive salary and a pension plan with matching contributions.
    • Flexible health and financial benefits to support you and your eligible dependents—from day one.
    • True work-life balance. Be at your best through paid time off, flexible work arrangements, volunteering opportunities, social events, and so much more.  

    About us
    Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, building the bridge between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization’s unique context into technology systems that amplify human potential, realize tangible returns and keep global enterprises ahead in a fast-changing world. See how at www.cognizant.com or @cognizant.

    Other employment-related information
    Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, provincial or local laws.

    If you have a disability that requires reasonable accommodation to search for a job opening or submit an application, please email [email protected] with your request and contact information.

    Language requirements vary depending on roles, but we ask that all candidates have basic English proficiency for company-wide communications purposes. For roles based in Quebec, professional English proficiency is required, as you’ll deliver services to and collaborate with stakeholders outside the province who may not speak French.