Essential Duties & Responsibilities:
• Coordinating and gathering all necessary information for the successful set-up of new clients, groups and providers by professionally acquiring information from the provider or office staff.
• Compiling and maintaining current and accurate data for all providers in the TriZetto credentialing database, including data entry for all new clients into credentialing software.
• Support the completion of provider initial and re-credentialing applications, provider change forms and letters and successfully following up with Third Party insurance carriers as needed.
• Maintaining copies of current state licenses, DEA certificates, malpractice factsheets, while tracking said requirement’s validity.
• Acting as first point of contact for TriZetto Credentialing clients; frequent email and phone communication.
• Assisting in the auditing of health plan directories as well as CAQH to ensure practice/provider demographics remain accurate and current.
• Leading client conference calls and presenting material effectively to clients.
• Interfacing regularly with internal Departments and Credentialing Clients regarding credentialing related inquiries and operations issues.
• Maintaining confidentiality with regards to any disciplinary actions or malpractice suits.
• Providing first-level reporting out of credentialing software.
• Assisting the Credentialing Team with additional administrative tasks, as assigned.
Summary of Qualifications
• High School Diploma or GED required;
• No experience in credentialing, provider enrollment, or related field desired, but not required
• Experience with PECOs, NCQA Standards, CMS regulations related to credentialing and conducting web-based research is desired, but not required.
• CPCS or CPMSM Certification is a plus.
• Proficient use of Microsoft Office applications (Excel, in particular), internet resources and Adobe Acrobat.
• Complying with HIPAA policies, Company Policies and federal/state laws
Salary and Other Compensation:
Applications will be accepted until 12/30/2024
The annual salary for this position is between $45,000 – $52,000, depending on experience and other qualifications of the successful candidate.
This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.
Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
· Medical/Dental/Vision/Life Insurance
· Paid holidays plus Paid Time Off
· 401(k) plan and contributions
· Long-term/Short-term Disability
· Paid Parental Leave
· Employee Stock Purchase Plan
Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Cognizant will only consider applicants for this position whom are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.
The Cognizant community:
We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive.
- Cognizant is a global community with more than 300,000 associates around the world.
- We don’t just dream of a better way – we make it happen.
- We take care of our people, clients, company, communities and climate by doing what’s right.
- We foster an innovative environment where you can build the career path that’s right for you.
About us:
Cognizant is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant (a member of the NASDAQ-100 and one of Forbes World’s Best Employers 2024) is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com
Our commitment to diversity and inclusion:
Cognizant is an equal opportunity employer that embraces diversity, champions equity and values inclusion. We are dedicated to nurturing a community where everyone feels heard, accepted and welcome. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other protected characteristic as outlined by federal, state or local laws.
Disclaimer:
Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.
