Job Description

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for a Business Analyst, for one of our largest clients in Detroit, MI!

Job Title: Business Analyst
Duration: 12 months
Location: Detroit, MI
Schedule: Onsite

SUMMARY

Process practitioner and organizational provider applications for credentialing based on State and Federal regulations and NCQA accreditation standards.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Responsible for the processing of practitioner and organization/facility provider applications for
• credentialing and recredentialing; requesting primary source documentation; processing documentation
• requirements, verifying information received, updating information in the system  of record, evaluating over
• all case categorization and reporting findings to the Medical Director and Enterprise Credentialing
• Committee.
• Resolve inquiries related to credentialing file disposition.
• Provide credentialing status information for group administrators, physicians and their staff, Provider
• Services, Customer Service and Network Development Inquiries.
• May be designated by the leader to attend Credentials Committee meetings and conduct internal meetings and
• participate in auditing processes.
• Assist with special projects and job aids as needed.

EDUCATION AND EXPERIENCE

• Associate degree preferred.
• Two (2) to five(5) years of work experience in provider enrollment, contracting, medical practice or hospital business office roles, and/or credentialing-related field required.
• Knowledge of related state/federal regulations, NCQA, DIFS, MDHHS, and CMS standards for credentialing required. 
• Knowledge of CAQH required.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OTHER SKILLS AND ABILITIES

• Excellent organizational skills with attention to detail required.
• Excellent verbal and written communication skills required.
• Ability to handle and prioritize multiple case files and timelines required.
• Ability to work effectively independently or in a team environment required.
• Intermediate knowledge of Microsoft Word, Excel, Access, PowerPoint, and internet use required.
• Excellent interpersonal skills and the ability to interact with internal/external customers.

ADDITIONAL INFORMATION

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

“Beware of scams. S3 never asks for money during its onboarding process.”