Franklin, United States
12 months ago
This position is accountable for all functions through the initial review of the Onboarding process to assure that physicians meet the health plan's requirements for employment as a contracted physician.
Processes provider applications by reviewing for credentialing, loading, and contract requirements.
Ensures compliance with CIGNA, NCQA, and state mandates as defined by our policy and procedures.
Gathers providers information, updates customer workflow tool, and communicates with providers by phone, email, or mail regarding Onboarding status and missing information needed.
Discrepancies associated with provider information submitted may require telephonic outreach to validate and verify health care professionals credentials.