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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.

    The Cognizant community:
    We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive.

    • Cognizant is a global community with more than 300,000 associates around the world.
    • We don’t just dream of a better way – we make it happen.
    • We take care of our people, clients, company, communities and climate by doing what’s right.
    • We foster an innovative environment where you can build the career path that’s right for you.

    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.

    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, state or local laws.

    Disclaimer: 
    Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

    Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.

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