Physician Licensing & Credentialing Representative- eviCore

Physician Licensing & Credentialing Representative- eviCore

Physician Licensing & Credentialing Representative- eviCore

Job Overview

Location
Franklin, Kentucky
Job Type
Full Time Job
Job ID
52815
Date Posted
3 months ago
Recruiter
Julia Hart
Job Views
206

Job Description

**This position will transition into the eviCore Franklin, TN office after COVID-19 restrictions are lifted.

This position is accountable for all functions of the physician credentialing process to assure that physicians meet the health plan's requirements for employment as a contracted physician.

Responsibilities include:

  • This position is accountable for all functions of the credentialing physicians into the eviCore plan. Processes physician applications and re-applications, including the initial mailing, review, and loading.
  • Ensures compliance with NCQA standards through maintenance of all necessary documents and verifications May assist in the implementation of procedures and activities related to the credentialing, re-credentialing and privileging of providers.
  • Maintains and reviews physician information relating to state licenses, DEA certificates and any other credentialing documents.

  • Gathers and completes all necessary documentation and paperwork completely and accurately for all applications.

  • Identifies issues that require addition investigation and evaluation, validates discrepancies and ensures timely and appropriate follow up.

  • Conducts thorough background investigation, research and primary source verification of all components of the application file.

  • Upon license renewals, obtains documentation from the physician and medical boards, as well as obtain primary source verifications from medical boards website(s).

  • Communicates with physicians by phone and mail regarding credentialing status and information. Issues tend to be routine in nature.

  • Good knowledge and understanding of Credentialing and business/operating processes and procedures.

  • Works to clearly defined procedures under close supervision.

Minimum Education, Licensure and Professional Certification requirement:

  • High School Graduate with diploma or GED. 

  • Associates/Bachelors degree preferred

Minimum Experience required (number of years necessary to perform role):

  • Administrative work 1-2 years required

  • Experience with Credentialing Preferred

          

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Job ID: 52815

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