Credentialing Specialist – Primary Source Verification

IntelliCVO is a Wholly owned subsidiary of IntelliSoft Group.  It is certified by the National Committee of Quality Assurance (NCQA).  It is positioned for both organic and inorganic growth along with the growth that will come with the effective launch of the IntelliSolution product line that was introduced in the 4th quarter of 2016.

Key Responsibilities

Receive, review, data enter & process all practitioner initial & reappointment applications according to NCQA standards & those required by client as outlined in client contracts.

Manage expiring credentials for all practitioners as required by client.

The selected individual will be able to perform the following tasks and as such will be responsible for assuring the following activities are completed efficiently:

  • Insuring that each credentialing file is complete and contains all documents and other important information needed for credentialing.
  • Accurate and timely completion of data entry so that credentialing can proceed without delay.
  • Credentials verification of physicians, allied health and other health care providers for whom the client is obligated by policy or industry standard to perform primary source verification.
  • Ongoing communication with practitioners being credentialed so that any missing information is obtained in a timely manner.
  • Ongoing follow up with 3rd party organizations providing the information needed for verifications.
  • Timely completion of credentialing files to meet important deadlines and target dates belonging to each client and revenue goals of the CVO.
  • Timely creation of credentialing status reports that are sent to CVO clients including those related to Expiring Credentials Management.

Skills/qualifications

Comfortable with computer skills such as typing, data entry and general computer usage.

Comfortable with Microsoft Word, Outlook and Microsoft Excel.

Able to work in an office environment in Nashua, New Hampshire.

Healthcare experience and credentialing experience a plus.

Education

High School Diploma or GED required.

College courses and or college degree preferred.

Please send your resume to:  ISGCVO@intellisoftgroup.com