Credentialing Specialist II Job:
Blue Cross and Blue Shield of Minnesota

20422-en_US
Blue Cross and Blue Shield of Minnesota
Eagan Minnesota
Healthcare
Description

For more than 80 years, Blue Cross and Blue Shield of Minnesota has been passionate about improving health. We provide quality, cost-effective health plans and innovative programs that make a healthy difference in people’s lives. Blue Cross is the largest health plan based in Minnesota, covering nearly 3 million members in the state and across the country. We strive to help all Minnesotans overcome the barriers to good health.



 



We offer our employees a comprehensive benefits, compensation and total rewards package to keep you and your family healthy and to secure your financial future. Our Employee Resource Groups help us advance health equity while promoting a diverse and inclusive work environment. Join us and make a healthy difference in people’s lives through the work you do every day. Together, we'll make Minnesota a better place to live — and a healthier one.


Description Summary

This position is responsible for activities associated with the credentialing process and completing the set-up and maintenance of practitioner and provider information on the provider databases. These activities will adhere to regulatory agency credentialing requirements, such as NCQA, Dept of Health, Medicare, TRIWEST and Blue Cross Blue Shield Association

Accountabilities


  1.  Determine credentialing status by screening and assessing all credentialing materials. Research, analyze and process routine credentialing cases

  2. Set up and maintain accurate provider and practitioner information on the provider databases, which are used for consumer initiatives with Blue Cross.

  3. Respond to customers regarding provider and practitioner eligibility and credentialing decisions and/or related issues.

  4. Maintain credentialing quality and production performance metrics.

  5. Contribute to process improvements to ensure an efficient operation.

  6. Special projects as assigned.


Requirements


  • High school diploma and 4 years customer service experience.

  • 1 year experience in the area of Provider Credentialing.

  • Ability to handle multiple tasks or projects. 

  • Detail-oriented with a quality focus.

  • Ability to work independently and demonstrate problem-solving skills. ·


Preferred Requirements

FLSA Status

Non-Exempt

Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



 



Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association

Basic Qualifications
Requirement