VSP Vision is a doctor-governed, not-for-profit vision benefits company that consists of business segments that collectively offer eye care insurance, eyewear,
Credentialing Specialist
Location
Worldwide
Posted
58 days ago
Salary
$58.7K - $80.3K / year
Seniority
Senior
No structured requirement data.
Job Description
Credentialing Specialist
VSP Vision
Credentialing Specialist remote type Remote locations Remote US time type Full time job requisition id R-9379 Develop and cultivate productive relationships with providers, retail chains, strategic partners, and their staff. Elevate providers’ understanding of industry standard credentialing requirements, leveraging team knowledge and resources. - Establish relationships with providers to obtain required regulatory information and manage all aspects of the providers’ initial and ongoing credentialing requirements - Use independent judgment to ensure that documentation complies with appropriate state regulations - Oversee and manage assigned files in the CVO partner’s system - Track in-progress credentialing files, identify and collect missing documents to ensure timely completion of the credentialing process for new and existing providers, and ensure that state regulatory standards are met - Research, analyze, and resolve complex credentialing issues and escalations, coordinating with internal and external business partners when needed, in order to meet compliance requirements - Use analytical and investigative skills to collect, evaluate, and compile information from regulatory reporting agencies, legal documents, and the provider to support the explanation of provider sanctions and/or malpractice claims - Compile required information for the Credentialing Committee in a clear and complete format that allows the Committee to render its decision on the provider’s application - Exercise critical thinking and analytical skills in the initial entry and maintenance of provider data, ensuring the integrity of all shared provider information - Escalate issues to the appropriate business areas and drive solutions when applicable - Gather and assess necessary provider information for the legal department to support the Dispute Resolution Process for providers denied at the Committee or terminated from the networl - Compose professional and concise correspondence to providers, retail chains, and office staff - Demonstrate a broad knowledge of the organization's strategic direction to achieve growth objectives and operational goals - Act as an internal resource for business partners Job Specifications Typically has the following skills or abilities: - Bachelor's Degree in a related field; in lieu of degree, 4 years of functional experience - Demonstrated professionalism and leadership in dealing with situations involving controversy and conflict, experience in handling and resolving escalated issues - Demonstrated advanced communication, influencing, and problem-solving skills - Experience working directly with providers and staff on credentialing policies and procedures - Regularly exercise discretion and independent judgment in the performance of job duties - Demonstrated ability to identify problems and provide creative solutions - Strong attention to detail, multi-tasking, organizational skills, and customer service skills - Proven ability to balance provider needs with corporate objectives - Ability to work independently and in a team environment #LI-VENTURES Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. Salary Ranges: $58,656.00 - $80,253.00
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Description Remote: This position does not require the employee to be on-site full-time to perform most effectively. The employee's role enables them to work off-site on a permanent basis. This position requires an employee to cover territory visits to dealerships on a recurring basis. The territory covers the Western Region/Market. The selected candidate must either currently reside in Phoenix, Arizona or within a 50-mile radius, or be willing to relocate to this area (within 50 miles). The Role The Regional Service Specialist serves as the primary liaison between Regional CCA leadership, brand subject matter experts, Service Operations, and internal work groups, acting as the key expert on service operations across the region. This role focuses heavily on emerging EV technologies and industry trends, dealer tools and equipment, technician training for both EV and ICE, and battery performance. 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All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, national origin, citizenship status, religion, age, disability, pregnancy or maternity status, sexual orientation, gender identity, status as a veteran or protected veteran, or any other similarly protected status in accordance with federal, state and local laws. We encourage interested candidates to review the key responsibilities and qualifications for each role and apply for any positions that match their skills and capabilities. Applicants in the recruitment process may be required, where applicable, to successfully complete a role-related assessment(s) and/or a pre-employment screening prior to beginning employment. To learn more, visit How we Hire. Accommodations General Motors offers opportunities to all job seekers including individuals with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, email us [email protected] or call us at 1-800-865-7580. In your email, please include a description of the specific accommodation you are requesting as well as the job title and requisition number of the position for which you are applying.
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