Credentialing Coordinator II

Job Title: Credentialing Coordinator II (Temporary one year or longer) Industry: Healthcare FSLA status: Non-Exempt Department: Operations Level: Entry to mid-level Location: Hybrid Pay Rate 20.00-20.29 Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting pay range for this remote role is 20.00-20.29. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate’s actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company’s growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. NTT DATA Services currently seeks a Credentialing Coordinator II to join our team for a one year temporary assignment with the possibility of becoming a permanent position. If you feel you are qualified by the description below, please apply for a chance to interview and discuss your skills & qualifications. You will join and work with a team of talented people who enjoy solving tough problems and improving the healthcare industry. They believe in supporting both personal and professional growth. That means, they pay attention to goals, celebrate milestones, and highly encourage learning opportunities. JOB SUMMARY Works with team members to ensure annual audits, pre-assessments, provider rosters, file reviews, and reports are accurate, complete, and meet client deliverable deadlines. Maintains delegated credentialing internal tracking tools to monitor performance. Provides compliance oversight for client reporting requirements and client corrective action plans. Collaborates with team members to respond to, investigate, and resolve issues identified in client corrective action plans, monitors, and documents progress. Acts as departmental liaison to client executives and health plan clients on order to support delegated credentialing activities. Provides timely response to health plan client and/or corporate audit requests, monitors, and documents progress. Assists in creating and updating delegated credentialing policies and procedures as directed to ensure compliance with NCQA and other applicable federal/state regulatory requirements. Summarizes and analyzes department key performance indicators and prepares weekly status report and reviews with team members. Monitors and tracks health plan client data and reporting requests. Collaborates with the provider credentialing team to review the accuracy and completeness of provider rosters/provider files and delivers to health plan clients. Identifies opportunities for process improvement. Performs reviews and quality controls of NCQA credentialing accreditation documentation, ensuring secure file exchanges, credential file preparation, etc. Works with business owner and subject matter experts to update documentation as needed for The Joint Commission accreditation surveys. Supports NCQA file audits to assess the quality of provider files. Reports findings to the Manager of Credentialing and Data Reporting for use in staff trainings. Partners with the Network Credentialing Reporting team to ensure the thoroughness and accuracy of all client deliverables including corrective action plans and corporate-wide audit JOB QUALIFICATIONS 3+ years of Healthcare Administrative experience 1+ year(s) of experience in Provider credentialing 1+ years of working with Excel and PowerPoint and Outlook 1+ years of experience with NCQA, URAC, CMS, and The Joint Commission 1+ years of experience working with provider enrollment, credentialing regulations and requirements High School Diploma or GED ESSENTIAL FUNCTIONS All duties and responsibilities are essential job functions and are subject to possible modification to reasonably accommodate individuals with disabilities. Other functions and accountabilities may be assigned from time to time. Regular attendance is an essential function of this position. To perform this job successfully, the employee will possess the skills, aptitudes, and abilities to perform each duty proficiently. TYPICAL PHYSICAL DEMANDS Requires sitting for long periods of time. Some bending, stretching or reaching required. Requires the physical dexterity to operate a keyboard, calculator, telephone, copier and other office equipment as necessary. Requires ability to perform data entry functions for 95% of the scheduled work shift and perform duties in a fast-paced environment with high demands and tight deadlines. Requires ability to view computer monitor for long periods of time without eyestrain. About NTT Data, Inc. NTT DATA, Inc. partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. NTT DATA, Inc. is part of the NTT DATA family of companies, together comprising a top 10 global business and IT services provider with 100,000+ professionals in more than 50 countries, and is part of NTT Group, a partner to 85 percent of the Fortune 100. Learn more at https://us.nttdata.com/en/. EEO Statement NTT DATA, Inc. (the “Company”) is an equal opportunity employer and makes employment decisions based on merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex sexual orientation genetic information, physical or mental disability, veteran or marital status, or any other class protested by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result. Job Types: Temporary, Full-time Pay: $20.29 per hour Schedule: Monday to Friday Education: High school or equivalent (Required) Experience: Microsoft Office: 1 year (Preferred) NCQA standards: 1 year (Preferred) URAC: 1 year (Preferred) Provider Credentialing: 1 year (Required) Healthcare Administrative: 3 years (Required) Work Location: Hybrid remote in Woonsocket, RI 02895