Credentialing Associate Salary in District of Columbia - District Average

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Average Salary for Credentialing Associate in District of Columbia - District Average

The average salary of a(n) Credentialing Associate in District of Columbia - District Average is $42,400.

The average hourly rate of a(n) Credentialing Associate in District of Columbia - District Average is $20.38.

The average bonus of a(n) Credentialing Associate in District of Columbia - District Average is $1,018.00.

Job Description:

Provides technical and clerical assistance to facilitate effective and efficient operation of the provider credentialing function. Analyzes and resolves basic provider issues relative to credentialing, enrollment, billing, and payers. Coordinates and performs enrollment of assigned providers and physicians in appropriate health plans to ensure satisfaction of the health plan requirement for acceptance. Typically requires experience sufficient enough to provide a working knowledge of NCQA and JCAHO. Reviews and processes provider applications and determines eligibility by applying NCQA, JCAHO, and URAC standards as related to the network. Performs primary source verification for initial and recredentialing of assigned providers utilizing NCQA and other Federal and State regulatory requirements. Communicates with providers regarding credentialing status and information. Creates and maintains participating provider or practitioner credentialing files. Reviews and analyzes provider file changes. Creates practitioner profiles for recredentialed practitioners. Prepares and sends application packets to participating providers and facility applicants, requesting the return of basic credentialing information. Reviews applications for completeness and assists the applicant in completing the application. Prepares routine credentialing reports. Less

Provides technical and clerical assistance to facilitate effective and efficient operation of the provider credentialing function. Analyzes and resolves basic provider issues relative to credentialing, enrollment, billing, and payers. Coordinates and performs enrollment of assigned providers and physicians in appropriate... More

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