Role: Credentialing Specialist Assignment: Provider visits Location: San Juan, Caguas, Ponce, Mayaguez, Barceloneta
Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At Humana, we’re seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.
Assignment Capsule Be a part of the Provider Network Operations world -- collaborate cross functionally to identify process opportunities to improve the provider experience.
Humana is seeking a Credentialing Specialist
Specialist to collect and process data while directly responding to questions, handling issues, and providing guidance on transactions, inquiries or complaints from both internal and external customers.
Visit provider office to collect credentialing documents
Assist and guide providers or representative to complete credentialing documents and application
Responsible for receive and complete credentialing cases
Processes incoming provider applications and maintains existing contract and credentialing documents to ensure records and documents are complete accurate and compliant with regulatory agency and corporate requirements
Responds to inquiries from internal and external callers requesting credentialing status
Develop, maintain and provide various reports to present in the monthly Credential Committee
Collect data and input to spreadsheets and databases
This is a Variable Staffing Poolposition in which associates work flexible hours to meet business needs, with no guaranteed minimum or maximum number of hours in any week. VSP associates are paid hourly and receive limited benefits: Paid Time Off (PTO), Eligibility to participate in Humana's Partnership Savings Plan - 401(k), Business Travel Accident Insurance, Associate Well-being Programs (WOW, EAP, Great Deals, Helping Hands, Giving Together, etc.)
Role Essentials * High School Diploma
Computer and others electronically equipment friendly
Proficiency in all Microsoft Office Programs, e.g. Word, PowerPoint, Excel, Access, etc.
Strong organizational and time management
Ability to work independently
Capacity to maintain confidentiality
Team work and highly motivated
Ability to handle difficult situations, managing several activities or tasks simultaneous
Ability to meet deadlines
Ability to work under pressure
Ability to work on multiple task at the same time
Ability to work under minimum supervision
Associate’s or Bachelor’s Degree
Experience Visiting Medical offices
Reporting Relationships You will report to a PNO frontline leader. This area is under the leadership of the Operation Vice President
This is a Variable Staffing Pool positionin which associates work flexible hours to meet business needs, with no guaranteed minimum or maximum number of hours in any week. VSP associates are paid hourly and receive limited benefits: Paid Time Off (PTO), Eligibility to participate in Humana's Partnership Savings Plan - 401(k), Business Travel Accident Insurance, Associate Well-being Programs (WOW, EAP, Great Deals, Helping Hands, Giving Together, etc.)
At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.
Title: Credentialing Specialist/Providers Visitor - Temporary role with Limited Benefits (Travel 80% Island wide. ) San Juan, Caguas, Barceloneta, Ponce and Mayaguez
Location: Puerto Rico-San Juan
Other Locations: US-Puerto Rico-Caguas, US-Puerto Rico-Mayaguez, US-Puerto Rico-Ponce, US-Puerto Rico-Barceloneta
Requisition ID: 179051