RELX Group Credentialing Analyst in Alpharetta, Georgia

Credentialing Analyst

Category:

Location: Alpharetta, Georgia, United States

Fulfills the regulatory (FCRA, GLBA, DPPA, FTC orders, Attorneys General order), data provider and company requirements for the different business units, which reduce the likelihood that accounts will be used for illegal activity or for non-permissible purposes. Conducts credentialing of applicants and customer updates to existing accounts. Will follow detailed, complex processes to determine a pass or fail status for each request. Will utilize a variety of tools and systems to perform research and to assist with decisioning. Will communicate via phone and email to customers and to internal parties such as Sales, Onboarding, Legal, and IADP to fulfill the credentialing requirements. Position operates across all Credentialing lines including Maintenance, New Business, Insurance and Project work.

Accountabilities:

  • Ensures accurate verification of applicants and existing customer information to determine a pass or fail by following documented policies and procedures to uphold regulatory requirements, data provider contractual requirements, and internal policies to ensure legitimate customers and to reduce the likelihood that accounts will be used for illegal activity or for non-permissible purposes within stated service level agreements. 80%

  • Manage a working queue and orders being processed so that productivity, accuracy and SLA goals are met.

  • Conducts credentialing based on the type of request or order, accurately following the complex documented policies and procedures.

  • Utilizes multiple products and tools to verify and document that credentialing standards are met.

  • Communicates with applicants and customers daily to obtain needed documentation or information to complete the credentialing process and communicates the final decision, via phone and/or email.

  • Makes an accurate final, pass,or fail decision.

  • Documents all interactions and documentation, recording details of findings and communications as well as actions taken while credentialing in the credentialing tool (MBS-ECT) for FTC, vendor provider and other audit purposes and data retention requirements.

  • Attends required training on policy and procedure updates as scheduled, usually quarterly, and a refresher training annually. Accurately applies the new information as trained when performing credentialing.

  • 45 updates per year on average.

  • Perform other duties as assigned.

Qualifications:

  • Bachelor’s degree or equivalent experience required.

  • 1-3 years industry experience detailed below a. Credentialing experience preferred or experience working with relevant regulatory environment (e.g. FCRA, GLBA, DPPA, FTC orders, Attorneys General order, etc.)

  • Detail oriented with a critical degree of accuracy regarding data entry and analysis, ability to deal with confidential data.

  • Proficient knowledge of computer-based software such as Windows, Internet Explorer, Microsoft Office and web-based products and tools. Will utilize relevant LexisNexis products and tools (e.g. MBS, Accurint, etc.) and external verification tools (SOS, etc.) on daily basis.

  • Excellent oral and written communication

  • Experience in customer service environment preferred.

LexisNexis Risk Solutions (www.lexisnexis.com/risk) is a leader in providing essential information that helps customers across all industries and government predict, assess and manage risk. Combining cutting-edge technology, unique data and advanced scoring analytics, we provide products and services that address evolving client needs in the risk sector while upholding the highest standards of security and privacy. LexisNexis Risk Solutions is part of RELX Group plc, a leading publisher and information provider that serves customers in more than 100 countries with more than 29,000 employees worldwide. LexisNexis Risk Solutions is an equal opportunity employer: qualified applicants are considered for and treated during employment without regard to race, color, creed, religion, sex, national origin, citizenship status, disability status, protected veteran status, age, marital status, sexual orientation, gender identity, genetic information, or any other characteristic protected by law. If a qualified individual with a disability or disabled veteran needs a reasonable accommodation to use or access our online system, that individual should please contact 1.877.734.1938 or accommodations@relx.com.