The Credentialing Department verify credentials for physicians and mid level providers that want to accept Customer insurance and see our members. Prior to listing the providers in the directory, a review of credentials outlined by the state and NCQA is performed. Providers are then approved by the Medical Director if clean and/or discussed by a physician panel if issues were found. This team will verify and analyze this information to determine if data is clean or has issues which drives the path of approval or denial.
Credentialing Rep II:
- Communicate, verbally and in writing, with providers to determine accuracy and/or clarification of information provided on applications
- Verify credentials and analyze the information to determine appropriate review paths
- Document issues for physician panel preparation
- Finalize files (perform audits) for quality review
- Work files from a work queue within timelines mandated by the state and NCQA
Computer literacy with attention to detail a must.
About Kelly Services ®
Kelly Services, Inc. (NASDAQ: KELYA, KELYB) is a leader in providing workforce solutions.
Kelly ® offers a comprehensive array of outsourcing and consulting services as well as world-class
staffing on a temporary, temporary-to-hire, and direct-hire basis.
Serving clients around the globe, Kelly provides employment to more than 560,000 employees annually.
Revenue in 2012 was $5.5 billion.
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Kelly founded the temporary staffing industry in 1946, and has maintained a leadership position through the years based on a valuable...