Network Health WI

Representative

• Support personnel for Credentialing and Provider Informatics
• Aid provider data management and provider credentialing needs
• Maintain accurate provider information across all lines of business
• Support provider onboarding, credentialing, recredentialing, provider data integrity, regulatory compliance, and provider inquiries
• Maintain accurate provider demographic, contract and credentialing data across systems
• Coordinate and aid in credentialing, recredentialing and ongoing monitoring needs
• Research and resolve provider data discrepancies
• Respond to provider inquiries via email, phone, and other channels
• Support NCQA, CMS, delegation and audit requirements
• Maintain credentialing policies, desk references and process documentation
• Partner with internal departments and provider offices to resolve issues
• Identify and implement process improvements and automation opportunities
• Protect confidential information and comply with organizational security policies
• Perform additional duties as assigned

Provider Integration Representative