All roles

QC Analyst- Credentialing compliance 100% REMOTE

Remote · USA Full-time New today

QC Analyst- Credentialing compliance 100% REMOTE Pay rate: $23.50/hr W2 6 months contract Remote but EST timezone Client is seeking an analyst experienced in health care or health plan compliance monitoring and auditing to join our Credentialing and Payer Delegation team. This position supports the credentialing compliance monitoring program activities, auditing, data collection, trend analysis and meeting timeliness for delegated payer deliverables.

  • Assists in the preparation of deliverables for payer and internal audit requests
  • Assist with credentialing tasks as needed
  • Building and maintaining effective, positive internal and external customer relationships
  • Conducting ongoing monitoring to evaluate levels of regulatory credentialing and delegated payer compliance with contractual and requirements
  • Exhibiting *** Heart at Work Behaviors
  • Participating in team initiatives and projects and meeting deadlines and quality expectations
  • Participates in the development and ongoing implementation of quality improvement activities. Improve quality products and services, by using measurements and analysis to process, evaluate and make recommendations to meet QM compliance objectives
  • Performing credentialing business process functions as needed, performing scheduled and random credentialing file audits
  • Reviewing risk assessments while participating in ongoing monitoring and annual program evaluation and identification of areas where there can be process improvement

Experience: 3+ years of related health care or health plan experience in credentialing compliance, auditing, and quality assurance Proficient in Microsoft Office Applications; Excel, Outlook, Word, and Teams The ability to create spreadsheets, analyze data and identify trends. Strong attention to detail and the ability to multi-task in a fast-paced environment MDStaff experience is preferred Remote About the Company: Veterans Sourcing Group Apply tot his job Apply To this Job

Related roles

Certified Credentialing Specialist – Work From Home

Remote · USA Full-time

Behavioral Health Intake Coordinator, MSW, Per Diem

Remote · USA Full-time

PT Remote Insurance Credentialing, Provider Info, EFT and ERA Specialist

Remote · USA Full-time

[Hiring] Intake Coordinator - Behavioral Medicine @Cincinnati Children's

Remote · USA Full-time

Client Intake and Rates Coordinator job at Clyde & Co in Kansas City, MO

Remote · USA Full-time

Insurance Verification Specialist

Remote · USA Full-time

Remote Insurance Collector

Remote · USA Full-time

Bilingual Insurance Verification Specialist (Full-Time Remote)

Remote · USA Full-time

Hybrid MDS Coordinator - RN - DAILY PAY OPPORTUNITY!!!

Remote · USA Full-time

Quality Practice Advisor

Remote · USA Full-time

Senior Interim Manager, Business Development (6-12 Month Contract)

Remote · USA Full-time

Experienced Customer Service Representative – Work From Home Opportunity at arenaflex

Remote · USA Full-time

Secondary Teacher, English/Language Arts (6-8)

Remote · USA Full-time

Senior Customer Success Manager

Remote · USA Full-time

Experienced Customer Engagement Manager – Crafting Unforgettable Experiences for arenaflex Customers

Remote · USA Full-time

Director of Real Estate & Construction

Remote · USA Full-time

Experienced Senior Customer Support Representative – Medicaid Provider and Member Services

Remote · USA Full-time

Experienced Customer Service Representative – Work From Home Opportunity at arenaflex

Remote · USA Full-time

Experienced Full Stack Data Entry Specialist – Remote Opportunity for Teens and Entry-Level Professionals

Remote · USA Full-time

Experienced Data Entry Clerk – Remote Opportunity with arenaflex

Remote · USA Full-time