- Mount Sinai Health System (New York, NY)
- **Job Description** The Provider Data Management and Credentialing Specialist is responsible for ensuring the data integrity for contracted ... across the departments multiple processes such as Credentialing and Provider Data Management activity. 2. Participates in ongoing sanctions monitoring… more
- Bassett Healthcare (Cooperstown, NY)
- …quality assurance reviews and support the Quality Improvement Plan + Systems & Data Management + Manage credentialing databases (eg, Verity Stream/Credential ... Credentialing and Enrollment oversees all aspects of provider credentialing , recredentialing, and enrollment processes, ensuring...work queues to ensure timely and accurate follow-up + Provide accurate data on attending and referring… more
- Molina Healthcare (NY)
- …delivery + Overseeing implementation of scalable solutions for provider onboarding, data management , and credentialing operations + Leading change ... **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new… more
- Mohawk Valley Health System (Utica, NY)
- …maintaining a database of provider information. Core Job Responsibilities + Provider Credentialing - works with insurance provider representatives to ... Data / Credentialing Specialist - Full...Credentialing Specialist (DCS) must have knowledge of the provider credentialing software to independently make changes,… more
- Highmark Health (Albany, NY)
- …progressive experience. Grandfathered experience requirements effective August 2016. + Experience in Provider Data Management , Customer Services or Claims. + ... applications and re-applications including initial mailing, review, and loading. Maintains provider data base and communicates with providers by phone and… more
- Hudson Headwaters Health Network (Queensbury, NY)
- …to provider support and credentialing as assigned by the provider support credentialing management team + Maintains compliance with appropriate ... written and verbal follow-ups on credentialing and provider support center requests + Provide administrative... orientation, and executing additional tasks assigned by the Credentialing management team. + Follow 50+ departmental… more
- University of Rochester (Albany, NY)
- …Professional Medical Services Management upon hire preferred + Certified Provider Credentialing Specialist (CPCS) upon hire preferred The University of ... affiliate hospitals. + Develops and maintains the electronic privileging data and criteria within the credentialing software...of improvement and implement changes as needed. Maintains account data to provide accurate reporting on active… more
- ASM Research, An Accenture Federal Services Company (Albany, NY)
- …or GED; Bachelor's Degree in healthcare or business field preferred + Certified Provider Credentialing Specialist (CPCS) preferred + 2-5 years of experience ... Processes credentialing and re- credentialing applications for the...current references. + Conducts queries through the National Practitioner Data Bank (NPDB), the Defense Practitioner Data … more
- CVS Health (Albany, NY)
- …accurately. The specialist maintains Credentialing systems and collaborates closely with Provider Data Services and the Verification teams to ensure timely ... and every day. **Position Summary** Assists in maintaining information in Credentialing databases. Reviews and validates provider information against business… more
- Highmark Health (Albany, NY)
- …insurance or managed care + 1 year in customer service + Certified Provider Credentialing Specialist (CPCS) **OR** Certified Professional Medical Services ... Description :** **GENERAL OVERVIEW:** This job coordinates and implements the credentialing and privileging activities within the Credentialing and Privileging… more
- Molina Healthcare (NY)
- …**Job Summary** Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk ... daily/weekly production goals and maintaining a high level of confidentiality for provider information. **Job Duties** * Evaluates credentialing applications for… more
- Healthfirst (NY)
- … management , including provider contracting, provider data management , directory data quality, credentialing , and other areas that impact the ... develops, and recommends strategic plans to ensure modern and efficient claims management and provider payment + Analyzes, evaluates, develops, and leads… more
- Molina Healthcare (Rochester, NY)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (Syracuse, NY)
- …design solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience, Enrollment, and Claims ... equivalent combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or equivalent… more
- Molina Healthcare (Albany, NY)
- …contracting, network management and credentialing . **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Aspen Dental (East Syracuse, NY)
- …**Preferred Skills** + Experience with electronic health record (EHR) systems and provider data management tools. + Excellent organizational skills ... application delays, denials, or discrepancies in provider data . + Responds to requests from management ,...years of management or supervisory experience in provider enrollment, credentialing in a health care… more
- Immigration and Customs Enforcement (Batavia, NY)
- Summary The Psychiatric Advanced Practice Provider delivers psychiatric care to ICE detainees, including evaluations, treatment plans, medication management , and ... performs functions as outlined in the IHSC Psychiatric Advanced Practice Provider Collaborative Practice and Prescriptive Authority Agreement and the IHSC formulary.… more
- Molina Healthcare (Buffalo, NY)
- … databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of ... business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of… more
- Molina Healthcare (Syracuse, NY)
- …timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, ... business rules as they apply to each database. Validate data to be housed on provider databases...requirements of customers as it pertains to contracting, network management and credentialing . **Job Duties** This role… more
- Molina Healthcare (Rochester, NY)
- …as related to transitions and implementations of existing plans with regards to provider data . + Organizational expert in responding to legislative and ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more