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Credentialing Auditor
DescriptionSummary:Responsible for auditing all complete credentialing applications and to build sound, effective and efficient audit processes.Coordinate and execute credentialing audits by analyzing provider files for completeness, accuracy, consistency, gaps in employment history, pertinent references, etc.Prepare credentialing audit reports and assist in the development of staff training guides, policies, and procedures.Manages multiple concurrent audits, plan audits, and related projects while ensuring that all audit tools meet NCQA, TJC, and CMS requirements.Responsible for educating and re-educating Associates.Maintains strict confidentiality over all information and data.Completes
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