Credentialing Sr Associate

Company Name:
Cigna
The successful candidate will be responsible for all aspects of the credentialing and re-credentialing process including assessing risk, Sanctions Monitoring and Medicare Opt Out processes to ensure compliance with Cigna's policies, as well as NCQA and Compliance Standards for Medical, Behavioral and Dental businesses.
Responsibilities:
Reviews Credentialing and Re-Credentialing files to determine risk and documents summaries of all risk files requiring Credentialing Committee Review
Reviews all newly identified sanctions and documents summaries of all sanctions requiring Credentialing Committee review
Ensures documentation is prepared in time for committee packet mailing deadline
Ensure timely and professional communication with internal/external customers as needed in order to expedite timely resolution
Correct any elements listed on the Errors/Quality reports as well as any other identified reports
Reviews Medicare Opt Out lists to determine eligibility for Medicare products including timely reporting of results
Consistently performs to department accuracy and quality audit standard results while maintaining timeliness measures
Balance priorities and daily responsibilities and notify supervisor of any barriers
Completes assigned projects and corporate training within agreed upon timeframes
Qualifications/Skills
Excellent time management and organizational skills
Excellent critical thinking and problem solving skills
Strong attention to detail and quality results
Deadline oriented and accountable for production
Effective oral and written communication skills
Microsoft Excel, Word, and Adobe knowledge
Quickly grasps new concepts
Associates degree or equivalent work experience
Job: Provider--Network/Data Mgmt
Title: Credentialing Sr Associate
Location: New Hampshire-Hooksett
Requisition ID: PS098837

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