Credentialing Specialist

This is a fully remote position, open to applicants in Arizona, +3 more states.

📋 Description

• Execute credentialing and re-credentialing tasks in alignment with plan specifications and NCQA standards.

• Liaise with physicians, office managers, providers, and other third parties to obtain necessary information.

• Collect data for Credentialing Committee meetings.

• Process, monitor, and organize credentialing applications within set standards.

• Create and employ reports to assist business operations.

• Conduct Primary Source Verification (PSV) for education validation.

⛳️ Requirements

• An Associate’s degree, or a high school diploma/equivalent, along with 1+ years of experience in data entry, customer service, medical office work, provider data management, credentialing, or healthcare operations.

• Preferably have experience in a managed care or insurance setting.

• Capable of performing PSV for education verification.

• Ability to excel in a fast-paced production environment while ensuring quality standards are met.

• Proficient in professional communication with physicians, office managers, providers, and other third parties.

• Skilled in generating and utilizing reports to facilitate business functions.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional incentive options may be included in the overall compensation package.