Customer Advocate – Entry Level Credentialing

Job Description

Customer Advocate – Entry Level Credentialing

What’s Next for you? This great job!

Kelly® is seeking a Customer Advocate with entry-level credentialing experience to work at a top insurance client in Richardson, TX. This is an excellent opportunity to grow your career and become a vital part of the community.

Snapshot

• Pay rate: $17.00 per hour
• Location: Onsite in Richardson, TX
• Schedule:
  • Training: Monday – Friday, 7:30 AM to 4:00 PM
  • Post-Training: Ability to select your own consecutive 8-hour shift, starting between 7:00 AM and 9:00 AM.
• Training: Paid training provided.

About the Role

As a Customer Advocate in an entry-level credentialing position, you will be responsible for the accurate and timely review and completion of Primary Source Verification Data for the credentialing and recredentialing of practitioners across multiple states. This role involves conducting thorough research, processing practitioner applications in adherence to company, state, and product requirements, and responding to inquiries from practitioner offices or internal departments regarding application status and supporting documentation.

Key Responsibilities

• Audit, monitor, and/or report defined elements necessary for credentialing and recredentialing activities, ensuring compliance with applicable regulatory agencies and HCSC internal credentialing policies and procedures.
• Verify the accuracy of specific provider data required for the Credentialing Provider Committee to review and decide on network participation for professional providers.
• Ensure professional providers applying for initial or ongoing network participation in Managed Care/Government products are credentialed or recredentialed timely and appropriately for presentation to the Medical Director Professional Provider Credentialing Committee, following NCQA/URAC/CMS and state regulations, guidelines, and standards.
• Collaborate with Network Management to collect deficient data or directly collect required data elements identified as customer service issues; ensure timely preparation and submission of provider credentialing files within specified days of being keyed into the system, and completion of recredentialing files prior to the assigned target date, in line with NCQA, URAC, CMS, and/or state regulations and guidelines.
• Query working databases to verify the status of practitioner applications.
• Verify and ensure the accuracy of information entered from network practitioner applications and/or re-credentialing packets into the Credentialing and Provider Data Systems, ensuring consistency with practitioner files in support of MCO and Compliance Policies and standards.
• Monitor returned applications from providers to ensure all required information has been submitted and applications are processed timely. If an application is incomplete, return it to Network Management or the provider with an Incomplete Notice detailing missing/deficient information. Track receipt and return dates of audited applications in the Credentialing system.
• Maintain a strong working knowledge and understanding of all Corporate, Compliance, and departmental policies, procedures, and regulations related to the credentialing verification process, including the laws of each state and NCQA/URAC/CMS guidelines and standards.
• Communicate and interact effectively and professionally with co-workers, management, and customers.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
• Maintain complete confidentiality of company business.
• Maintain communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.

Job Requirements

• High school diploma or GED (Education verification is required).
• 2 years of business experience. A combination of college-level education and experience will be considered.
• Clear and concise interpersonal, verbal, and written communication skills.
• Strong organization skills to handle multi-processes and multi-states.
• PC experience in Windows, Word, Excel, Access, and other business-related/associated databases.

What Happens Next

Once you apply, you’ll proceed to the next steps if your skills and experience align with our requirements. Even if this specific position doesn’t work out, your profile will remain in our network, expanding your opportunities as our recruiters will have access to it.

Helping you discover what’s next in your career is what we’re all about, so let’s get to work.

If qualified and interested, apply to be an eCredentialing Rep today!

Benefits and Perks

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. More information on benefits and perks that may be available to you as a member of the Kelly Talent Community can be found on our website.

About Kelly

Work changes everything. And at Kelly, we’re obsessed with where it can take you. To us, it’s about more than simply accepting your next job opportunity. It’s the fuel that powers every next step of your life. It’s the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Equal Opportunity Employer

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.